Kids & Youth - Sign Me Up
| First Name |
|
Initial |
|
Last Name |
|
| Address (Street # & Name) |
|
| Additional Space (& Apt #) |
|
| City |
|
Province |
ONTARIO |
| Postal Code |
|
Country |
CANADA |
| Home Phone # |
(
) |
Cell Phone # |
(
) |
| Male or Female |
|
Date of Birth |
|
| My Signature & Agreement to the Rules of the Card |
|
| Date of Signature |
|
I am between 6 and 18 years old: My Age |
|
| I go to school (Y/N) |
Grade |
I work (full-time/part-time/not/or want to) |
|
With my signature above, I understand that I must
follow the guidelines of event providers, and understand that negative behaviour
or my lack of adhering to the rules at these activities can negate my privilege
to be a KPYO member, and whereby I would forfeit my collected reward points
which would be cancelled on the basis of breach of this agreement.
I am a parent/legal guardian
of the above applicant, and agree/approve this application for the Points Card.
| Emergency # |
(
) |
Bus Phone # |
(
) |
| Relationship |
|
|
|
| My Signature & understanding of the Rules for my
Applicant |
|
| Could you volunteer? (Y/N) If so, in what capacity and what
is your availability? Thank you for playing your part for our next
generation... |
|
The above
application is for a Rewards Card for kids aged 6 through youth 18 only.
KPYO Card Members will be awarded points for participating in activities
with organizers that accept the Points Card around the GTA. Members will
be able to redeem the points for retail products & services from the on-line
Catalogue after 6 months of membership.
Earning while learning for a bright future…
KPYO Inc
KidsPlay & YouthOutlook
Tel & Fax:
416-813-0909
345 Bloor Street East,
Box 72533
,
Toronto
,
ON
M4W 3S9
Canada
Toll Free 1-877-762-7624
Log onto www.kpyo.net or e-mail info@kpyo.net
Print
this form and return it signed to an event near you; or
by fax; or by mail
going
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