Fly Fishing Canada

This registration form is for competitors registering as a team, not as individuals. Those wishing to register as an individual competitor should use the individual registration form.

* - denotes required field

	Date:	2010-02-08
Submitter Information:	First Name:
	Last Name:
	Team Name:
	Address:
	City:
	Prov:
	Postal:
	Country:
	Work Number:
	Home Number:
	Fax Number:
	Email:

Team Captain:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:

Team Member:	Name:
	Email:
	Telephone:
	Comments:
	To avoid unwanted spam we require that you enter the security code shown below in order to submit your inquiry.
	Type the characters you see in the picture below. Cannot write in captcha temporary folder: /var/hsphere/local/home/flyfishe/flyfishingcanada.net/includes/common/lib/captcha/../../_temp/.captcha/
	The Registration Fee is $300.00 Canadian Dollars per Competitor. Competitors can pay via check to the following address: Fly Fishing Canada c/o Diana Lavigne LaBarge Weinstein Professional Corporation A Business Law Firm 515 Legget Drive, Suite 800 Kanata, ON K2K 3G4 Registration is not complete until payment is received!