Adult Registration

To register with the Valley Recreation District, please use the following form below or download a printable version of the Adult Registration Form. For payment, please make a cheque payable to Prairie View Municipality.

Registrations can be dropped off at the VRD office in Birtle (684 Main St in the CDC building)

For Miniota community members registrations can be dropped off at the Municipal office in Miniota (111 Sarah Avenue) or Emailed to recreation@myprairieview.ca

All registrations are accepted on a first come first serve basis and Full payment is required to confirm your registration.

Contact VRD:
Phone: 1-204-842-3460
Email: recreation@myprarieview.ca

Adult Registration Form

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		<field type="text" subtype="text" required="true" label="Program Name" class="form-control text-input" name="text-1681830380482"></field>
		<field type="text" subtype="text" required="true" label="Name" class="form-control text-input" name="text-1681830406594"></field>
		<field type="text" subtype="text" label="Age" class="form-control text-input" name="text-1681830417579"></field>
		<field type="date" label="Date of Birth" class="form-control calendar" name="date-1681830461572"></field>
		<field type="textarea" label="Any Medical Conditions" class="form-control text-area" name="textarea-1681830471978"></field>
		<field type="text" subtype="text" required="true" label="Phone (Home)" class="form-control text-input" name="text-1681830486057"></field>
		<field type="text" subtype="text" label="Phone (Work)" class="form-control text-input" name="text-1681830495889"></field>
		<field type="text" subtype="text" label="Phone (Cell)" class="form-control text-input" name="text-1681830507472"></field>
		<field type="text" subtype="email" label="Email Address" class="form-control text-input" name="text-1681830518498"></field>
		<field type="text" subtype="text" label="Mailing Address" class="form-control text-input" name="text-1681830523169"></field>
		<field type="text" subtype="text" label="Emergency Contact" class="form-control text-input" name="text-1681830552186"></field>
		<field type="text" subtype="text" label="Emergency Phone" class="form-control text-input" name="text-1681830565241"></field>
		<field type="checkbox" required="true" label="I certify that I am in good health and I am able to participate in vigorous activities and or assume responsibility to make all instructors working with Valley Recreation District aware of any and all injuries or medical conditions. I authorize the director/instructors to seek emergency medical treatment if is is deemed necessary. This also assures that I release the instructors, Valley Recreation District, Prairie View Municipality and the program facilities from any and all liability from any injury or illness incurred going to the program from home, while at the program or returning home from the program. As well all liabilities for losses and damages of all and every description." class="checkbox" name="checkbox-1681830583410"></field>
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