First Name:

Last Name:

Mailing Address:

Postal Code:

Telephone: Home:    Work:

E-mail:

What Curling League interests you most? (Select one that may apply!) Men's League: Tuesday evenings Women's League Monday evenings    Monday Evenings  Tues/Thurs Afternoon Senior League     Men     Women      Senior Mixed Monday Junior League      Monday     Thursday Mixed League     Wed Mixed (8 ends)  Thurs (6 ends)  Friday (6 ends) Saturday League Mixed   Men's  Ladies Other Leagues    Special Olympics   ACT Sunday mornings

Are you interest in instructing or coaching? Yes No

If "yes" please indicated level of experience? Level 1 Technical     Level 1 Certified      Level 2 Technical     Level 2 Certified      Level 3 Technical     Level 3 Certified

Please indicate if you are interested in any of the following? Junior League Instruction School Program Instruction Bonspiels: (Please specify below!)     Seniors     Mixed     Men's     Women's

Would you be interested in volunteering for bonspiels. Yes No

Do you have your serving it right? Yes No

Do you have your food safe? Yes No

Comments or Questions: