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Multi Event Registration

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CM Registration

City Mosaic Registration

1 General Team

2 Team Leader Info

3 2nd Member Info

4 3rd Member Info

5 4th Member Info

6 Payment Info

General Team Information
Team Name*
Division*
- Adventurer (Full Race)
- Explorer (Half Race)
Information Session*
- Session 1: May 13, 2015 (Wed); 7:30pm – 8:30pm
- Session 2: May 13, 2015 (Wed); 8:30pm – 9:30pm

Team Leader Information
Name*
First Last
Email*
Enter Email Confirm Email
Cell Phone*
Gender*
- Male
- Female
Are you a member of Across U-hub?*
- Yes
- No
Home Phone*
Date of Birth*
Address*
Street Address City Province Postal Code
Country of Birth*
Ethnicity*
Year(s) in Canada*
How did you know about this program? (Check all that apply)*
- Friend
- Parent
- Booth
- Poster/Flyer
- Radio/TV/Newspaper
- Social Media(e.g. Facebook)
T-shirt Size*
- S
- M
- L
- XL
Emergency Contact Person*
Relationship*
Emergency Contact Cell Phone*

2nd Member Information
Date of Birth*
Phone (Home)
Phone (Cell)*
Place of Birth*
Education (School/Institution)*
Grade/Year*
Occupation*
Year(s) in Canada*
How did you find out about this event?*
- Friend
- Parent
- Promotion Booth
- Social Media (Facebook, Instagram, etc.)
- Pamphlet (Flyer, Program Highlight, Newsletter)
- Newspaper/TV/Radio
- Church
- Community Partner
- Other
If "Other" or "Community Partner", please specify*
Language(s) you speak*
- English
- French
- Spanish
- Cantonese
- Mandarin
- Others
If "others", please specify*
T-shirt Size*
- Small
- Medium
- Large
- Extra Large
Parent/Guardian's Name (if under 18)
Parent/Guardian's Email*
Parent/Guardian's Cell Phone*
Emergency Contact Person*
Relationship*
Emergency Contact Phone Number*
Health Card Number

3rd Member Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Gender*
- Male
- Female
Email*
Enter Email Confirm Email
I wish to receive program updates and news from Across U-hub in the future.
- Agree
Date of Birth*
Phone (Home)
Phone (Cell)*
Place of Birth*
Education (School/Institution)*
Grade/Year*
Occupation*
Year(s) in Canada*
How did you find out about this event?*
- Friend
- Parent
- Promotion Booth
- Social Media (Facebook, Instagram, etc.)
- Pamphlet (Flyer, Program Highlight, Newsletter)
- Newspaper/TV/Radio
- Church
- Community Partner
- Other
If "Other" or "Community Partner", please specify*
Language(s) you speak*
- English
- French
- Spanish
- Cantonese
- Mandarin
- Others
If "others", please specify*
Parent/Guardian's Name (if under 18)
Parent/Guardian's Email*
Parent/Guardian's Cell Phone
Emergency Contact Person*
Emergency Contact Phone Number*
T-shirt Size*
- Small
- Medium
- Large
- Extra Large
Health Card Number

4th Member Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Gender*
- Male
- Female
Email*
Enter Email Confirm Email
I wish to receive program updates and news from Across U-hub in the future.
- Agree
Date of Birth*
Phone (Home)
Phone (Cell)*
Place of Birth*
Education (School/Institution)*
Grade/Year*
Occupation*
Year(s) in Canada*
How did you find out about this event?*
- Friend
- Parent
- Promotion Booth
- Social Media (Facebook, Instgram, etc.)
- Pamphlet (Flyer, Program Highlight, Newsletter)
- Newspaper/TV/Radio
- Church
- Community Partner
- Other
If "Other" or "Community Partner", please specify*
Language(s) you speak*
- English
- French
- Spanish
- Cantonese
- Mandarin
- Others
If "others", please specify*
T-shirt Size*
- Small
- Medium
- Large
- Extra Large
Parent/Guardian's Name (if under 18)
Parent/Guardian's Email*
Parent/Guardian's Cell Phone*
Emergency Contact Person*
Emergency Contact Phone Number*
Health Card Number

Billing Information
Billing Name
First Last
Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Email
Enter Email Confirm Email
Billing Phone
Use a Promotion Code
City Mosaic
Price: $ 120.00 CAD
Total
$ 0.00 CAD

Volunteer Registration

Volunteer Sign Up

Sign up to volunteer
Name*
First Last
Gender*
- Female
- Male
Home Phone
Cell Phone*
Email*
Enter Email Confirm Email
Date of Birth*
Place of Birth*
Have lived in Canada since:*
MM
DD
YYYY
Emergency Contact Name*
Emergency Contact Phone #*
Emergency Contact Relationship*
How did you know about Across U-hub? (Please check all that apply)*
- Friend
- Parent
- Promotion Booth
- Social Media (Facebook, Instagram, etc.)
- Pamphlet (Flyer, Program Highlight, Newsletter)
- Newspaper/TV/Radio
- Community Partner
- Others

Tel:	+1 (905) 944-1944
Fax:	+1 (905) 944-1950
E-mail:	[email protected]
Address:	232 Hood Road, Markham, Ontario, Canada, L3R 3K8 (map)
Hours:	Monday-Friday: 10:00 AM-6:00 PM

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Across U-hub is a registered Canadian Charity # 849466164 RR0001
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