TOTAL BODY TRANSFORMATION CHALLENGE REGISTRATION FORM

First Name *

Last Name *

Age: *

Address: *

City or Town: *

Province: *

Postal Code *

Area Code *

Phone Number *

Email Address: *

REGISTRATION FEE *

FEE ($100 + $5 ADMIN FEE)

CLASS DIVISION

What division (s) are you competing in (check all that apply): *

What show are you participating in? *

Flex Lewis Canadian Classic, Moncton NB - Oct 29th 2022

Nfld & Labrador CPA Championships, St. John's NL - Nov 12th 2022

PEI Physique & Transformation Championships, PEI - April 15 2023

Weight (pounds) i.e. 156 lbs *

Height (feet/inches) i.e. 5'7" *

Chest (inches) *

Waist (inches) *

Hips (inches) *

Image #1 - Facing Front

Image #2 Side Pose

Image #3 Facing the Back

Image #4 Front Pose Holding Newspaper with Date

You can pay by e-transfer FOR NB/NL: *Please send an email money transfer for $105 to figure@heatherleblanc.ca

Question: What is this for?

Answer: Registration

You can pay by e-transfer FOR PEI: *Please send an email money transfer for $105 to info@stretchfitness.ca

Question: What is this for?

Answer: Registration

***ALL REGISTRATION FEES ARE NON-REFUNDABLE AND NON-TRANSFERABLE***