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

In Conjunction with which show? *

Atlantic Classic Championships - April 27th, 2024

Nova Scotia East Coast CPA Championships, NS - Date TBD

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: *Please send an email money transfer for $105 to figure@heatherleblanc.ca

Question: What is this for?

Answer: Registration

**YOUR REGISTRATION IS INVALID IF PAYMENT HAS NOT BEEN MADE**

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