Athlete Leadership Program Workshop Registration Form Special Olympics Ontario Community*Athlete Name* First Last Athlete Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Athlete Phone #*Athlete Email* Enter Email Confirm Email Which ALPs course are you attending?*Sat. Oct. 5th: Pembroke - Introduction to ALPsSun. Oct. 6th: Arnprior/Ottawa - Health MessengerSat. Oct. 26th: Thunder Bay - Speakers TrainingSun. Oct. 27th: Thunder Bay - Health MessengerSat. Nov. 2nd: Welland - Introduction to ALPsSat. Nov. 9th: Kingston - Speakers TrainingSun. Nov. 10th: Kingston - Speakers TrainingSat. Nov. 30th: Toronto - Speakers TrainingSun. Dec. 1st: Toronto - Health MessengerSat. Jan. 18th: Hamilton - Introduction to ALPsSun. Jan. 19th: Port Colborne - Health MessengerSat. Feb. 8th: Windsor - Introduction to ALPsSun. Feb. 9th: London - Health MessengerSat. Mar. 14th: Muskoka - Speakers TrainingSun. Mar. 15th: Muskoka - Health MessengerSat. Mar. 21st: Welland - Speakers TrainingSun. Mar. 22nd: Welland - Health MessengerSat. Apr. 17th: Sudbury - Speakers TrainingSun. Apr. 18th: Sudbury - Health MessengerSat. May 1st: Brantford - Introduction to ALPsSat. May 9th: Elliot Lake - Introduction to ALPsHow many years has the athlete participated in SOO Programs*Why are you interested in becoming an Athlete Leader?*Do you require any assistance with reading and/or writing? If YES, please give a brief description of how we can best assist you during the workshopWill you be bringing a mentor?*YesNoMentor Name First Last Mentor Email Enter Email Confirm Email Please outline any dietary restrictions for the athlete and/or mentor below. If no dietary restrictions are required, please simply state N/A* This iframe contains the logic required to handle Ajax powered Gravity Forms.