First Name


Last Name


Phone Number


How did you hear about us?


E-mail Address


Male    Female

Age


Event Date, Location & Desired Age Category
Friday Feb 10-12 Valley Zoo Age Group 1: 20-30 Friday Feb 10-12 Valley Zoo Age Group 2: 30-40 Friday Feb 10-12 Valley Zoo Age Group 3: 40-50 Friday Feb 10-12 Valley Zoo Age Group 4: 55-65 - Wait List for Ladies Saturday Feb 11-12 Valley Zoo Age Group 1: 25-35 Saturday Feb 11-12 Valley Zoo Age Group 2: 35-45 Saturday Feb 11-12 Valley Zoo Age Group 3: 45-55 Add Me to your Data Base Add me to your wait list!

  

If you are having problems with the above form just email us at info@eightminutedate.ca your Name, Age, Event Date and Age Category! Thanks Please submit your Pre-Registration we will then contact you with registration confirmation. We will also send you an email just prior to the event to confirm your attendance. It is very important that you show up for the event if you confirm your attendance as the success of event is dependant on equal men and women.
If you would like to use Pay Pal to ensure your spot please go to our Upcoming Events page. The cost of our regular events is $40.00. $45 for Special events which include diner!

If for any reason you are unable to register using the above form please email us your information to info@eightminutedate.ca