Log On |  FAQ |  français
HomeCoursesFacilitiesMembershipsMy Account
Step 1. Create Billing Contact
Step 2. Activate Account
Step 3. Account Activated

Contact Information       Note: Red text indicates required fields.
Billing First Name:
 Billing Last Name:
Address 1:
Country:
  
Prov/State:
  
City: 
  
Postal/Zip Code: 
  
Phone 1: 
  
Phone 2: 
  
Email: 
  
Client #: 
  
Job Title (En) :
  
Organization: 
 
Preferred Language: 
 
Job Title (Fr):
Account Information
Username:
* We suggest your email address (Min Characters: 5)
Password:
Re-Type Password:  

Password Strength
     

Note: For the best Password Strength rating include:
  • Uppercase and lowercase characters
  • Numbers
  • Symbols
  • Eight or more characters
Extra Information
Gender:
  Male     Female     X     Decline to Answer  
Birthdate:
      
Guardian 1 Name:
 
Guardian 1 Phone:
 
Guardian 2 Name:
 
Guardian 2 Phone:
 
Emerg. Contact:
 
Emerg. #:
 
SIN #:
 
Other Authorized Adults for Child Pick Up:
 
CTRV number:
 
Service Number:
 
Law number 9:
 
Firearms license number:
 
 
Types of weapons:
 
Expiry date firearms license:
      
Medical Information
Medical #:
 
List any medication presently taken:

Do you have any of the following conditions or requirements?:
Allergies:  YesNoEpi-pen Required:  YesNo
Head Injury:  YesNoAthletic Injuries:  YesNo
Assistance Required:  YesNoOther Medical Conditions:  YesNo

Please explain:  

Please list any other ailments that the staff should be aware:

Are there any other reasons why the client should not take part in physical activities?:

PAR-Q Completed
Security Check

Captcha Verification  


Next


About Us | Contact Us | Privacy Policy | Refund Policy | Terms & Conditions

© 2026 Univerus Sport and Recreation. All rights reserved.  |    (62)  |  Powered By  Univerus Rec