Staff Registration Form

Name:______________________________________________________________

Address:____________________________________________________________

___________________________________________________________________

Phone Number:_______________________________________________________

Email: ______________________________________________________________

Medical or Dietary Restirctions: __________________________________________

___________________________________________________________________

Health Card Number (Canadian): _________________________________________

Insurance Plan Number (American): ______________________________________

Expected Time of Arrival: Friday ............... AM _____                      PM _____

THERE ARE SEVERAL WAYS TO REGISTER. PICK ONE....

By snail mail: Copy the above registration form and then print it out on your computer (directions below). Then send it to the Jason Toner at the address below with a $25.00 staff fee cheque.

Electronically: Copy the above registration form (directions below) and type the appropriate information in the blanks, then email it to the email address below. Once your emailed registration is recieved, we will send you a confirmation letter to notify you that your registration has been recieved. You then need to send a $25.00 staff fee cheque in the mail to the address below. Your spot will be reserved for twenty-one days, and if your cheque is not recieved by then, your registration will be thrown out.

By phone: Call the number below and you will be asked to give the above information. Once your registration has been confirmed by phone, you are expected to send a $25.00 cheque within twenty-one days, or your registration will be thrown out.

INSTRUCTIONS FOR COPYING

To send in this form,
1) Simple highlight the form by click and draging
2) Right click on the highlighted area
3) Select copy
4) Minimize you internet window and open a word processor
5) Right click on the blank page and then select paste
6) Then just use the word processor to print the form

Mailing Address: Genesis Venturee
                           c/o Jason Toner
                           3523 St. Clair Parkway
                           Sombra, Ontario
                           N0P 2H0

Email Address: [email protected]
                                      or
                    [email protected]

Phone Number: (519) 892-3403