Varsity Registration Form
Email
Secondary Email
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Email address *
First name *
Last name *
Address 1 *
Address 2
City *
State *
ZIP Code *
Cell Phone Number *
Student Number: *
Years of Eligibility Used *
0
1
2
3
4
5
Height *
Gender: *
Male
Female
Other
Citizenship *
Domestic
International
Program Name: *
Years You have Participated at Centennial College *
1
2
3
4
5
Sport: *
Position: *
Campus: *
Have you Attended Another College or University: *
Yes
No
Hometown *
Name of College/University: (If you answered no to the previous question, please write Centennial College as your answer) *
City of Institution: *
Did you Play on the "Varsity Team" at that institution: *
Yes
No
Which Sport(s): *
Name High School(s) Attended: *
Number of Years Played at That Institution *
City of Institution: *
Emergency Contact Name: *
Relationship: *
Emergency Contact Email: *
Emergency Contact Phone: *
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