• Registration

Registration

	* First Name:
	* Last Name:
	* Location:	Please select a location.1270 Bank Street, (Ottawa South)Stittsville/Kanata 44 Iber Rd. Stittsville (located in Astral Fitness))Westboro 332 Richmond Rd (corner of Richmond and Churchill)Riverside South 665 Earl Armstrong Rd., Unit 7 (Tiny Hopper’s)Kemptville 200 Saunders Street (Giant Tiger Mall, lower level)Aylmer 61 Symmes Street
	* Adult	Please select the number of AdultsNo AdultsOne AdultTwo AdultsThree AdultsFour or more Adults
	* Child	4-6 years Please select the number of ChildrenNo Children 4-6 years of age.One Child 4-6 years of age.Two Children 4-6 years of age.Three Children 4-6 years of age.Four or More Children 4-6 years of age. 7-13 years Please select the number of ChildrenNo Children 7-13 years of age.One Child 7-13 years of age.Two Children 7-13 years of age.Three Children 7-13 years of age.Four or More Children 7-13 years of age. 14 and up Please select the number of ChildrenNo Children 14 years or up of age.One Child 14 years or up of age.Two Children 14 years or up of age.Three Children 14 years or up of age.Four or More Children 14 years or up of age.
	* Address:
	* City:
	* Province:
	* Postal Code:	example: K1S 3Y4
	* E-Mail:
		If you do not have an email account, please contact Douvris directly using the phone number for your Location.
	* Telephone Number:	example: 613-234-5000
	* Program of Interest:	Cardio Kickboxing Karate Athletic Conditioning Birthday Party (Members only - only available in Riverside South )
	* All students under the age of 18 must be accompanied by a parent or legal guardian at the Introductory appointment. * Unless otherwise indicated all fields are mandatory.

• Bank Street
• Aylmer
• Stittsville / Kanata
• Kemptville
• Riverside South
• Westboro

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