Scarberian Boxing Club Registration Form

2250 Midland Ave #29 Scarborough, Ontario M1P-4R9

Phone:647-501-1979 www.scarberianboxing.com

scarberianboxingclub@gmail.com

In case of emergency

Parent/Guardian Name [Required if participant is under 18 years of age]

Program registration

Please Enter Card Details:

Once you are done with the above, We will answer this part for you.

AGREEMENT, ASSUMPTION OF RISKS, AND WAIVER OF LIABILITY