Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

MD OF BIGHORN - COURSE REGISTRATION FORM

  1. FOIP Notification:

    Your personal information is protected by the privacy provisions of the Freedom of Information and Protection of Privacy Act. The personal information you provide on this form is being collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act. This information will be used for the purpose of registering for a community class. If you have any questions about the collection or use of this information please contact the FOIP Coordinator, at the MD of Bighorn at 403-673-3611.

  2. We must be able to contact you during the day.

  3. Disclaimer

    I certify that to the best of my knowledge, the participant named herein is physically fit and able to engage in the above named activities. In case of emergency, I give my permission for emergency treatment and hereby release the MD of Bighorn, and it's instructor from all claims for damages or loss arising form any accident or injury caused by or arises from the participation of the individual named herein during any program or in any facility or at any location where a program is being held, and agree not to sue the MD of Bighorn or it's instructor.

  4. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  5. Leave This Blank:

  6. This field is not part of the form submission.