BTG Registration Form Name: Street Address: City: Province: Postal Code: Home Phone: Work Phone: Cell Phone: Fax: Email (required): Birthdate (month/date/year): Disability (if spinal cord injury please indicate level and date of injury): Sports you are interested in: Basketball Floor Hockey Wheelchair Curling Quad Rugby Target Sports Tennis Wheelchair Racing   Would you like to receive information about the "Have a Go Days"? Yes No