To Register For the First Time:
Complete this form and submit it. You may choose your own Username and Password. Do not put any spaces in your user name. If you choose a user name that is already in use, you will need to choose another one. There is no charge, just sign up and register.

Registration Renewal: Just continue to use the program, there is no charge for renewal courtesy EDIS Computers and Recreation Penticton until September 2013.


* First Name:
* Last Name:
Address:
City:
Province:
Postal Code:
Registration ID:
Age:
Gender Male Female
Group:
* Phone:
* E-Mail:
* Re-enter E-Mail:
* User name:
* Password:
* Re-enter Password:
 
How did you hear about our Steps Out Program?
(check all that apply)
Radio
Newspaper
Word of Mouth
Recreation Brochure
Community Centre Staff
  Other:
* I have read and understand the PARQ - Click Here to View PARQ


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