C3 Canadian Cross Training Club 104 Maple Avenue, Inglewood, On., L0N 1K0 phone:(905) 838-2662 fax:(905) 838-0220 www.c3online.ca Homestay Request Form for Athletes HSBC ITU PAN AMERICAN CUP TRIATHLON FESTIVAL July 26 to July 30, 2005 PRINT THIS FORM FILL IT OUT AND FAX TO: 905-857-4566 ATTN: Darryl MacArthur

Yes! I would like to stay with a local family!
Please do not request a homestay if you can comfortably afford to stay in a hotel.

Athlete name:____________________________________________________________________________

Athlete address:__________________________________________________________________________

Athlete phone number:___________________________ Athlete e-mail:______________________________

What race are you competing in?_____________________________________________________________

Are you Male: Female: What language(s) do you speak?:__________________________________

Would you like to be with another athlete in the host home?: _______

If yes, who?:_________________________________________ Male: Female:

Would you share a bed with another athlete in the host home (spouse, sibling or team-mate)?: _____________

If yes, who?:________________________________________ Male: Female:

Do you have an allergy that the host must be aware of to make their home safe for you?:__________________

If yes, what is the allergy?___________________________________________________________________

Would you stay in a home with pets?________

Would you stay in a home where someone smokes?_________________________

What date do you expect to arrive?:_______________________________

What date do you expect to leave?:_______________________________________

When exactly are you arriving? If you have not finalized your travel plans, let us know as soon as you do.

Arrival Information: Airline:___________________ Flight:__________________ Arrival time:_________________

Do you have any other requests or concerns?_____________________________________________________

For more details, visit www.c3online.ca 

We hope you enjoy your stay with friends of C3.
All the information collected on this form is solely for the purpose of helping us match families and athletes.
This information will be kept confidential to C3, and sold or otherwise distributed.