Banner Text

Banner Slogan

Member Login
User Name:
Password:
Register
19002 60th Avenue
Surrey V3S 7W4
British Columbia
Canada
Tel 604-574-0405
Email Us

Registration Form

Focusing On Development

To Register: Complete the on line registration form in detail with the date and program you are attending. All registration fees are due and must be paid in full to confirm your registration. Cheque or Money orders made payable to: Pacific Titans Athletic Program 19002 60 Ave Surrey, BC V3S 7W4 Note: A receipt is available upon request and will be available for pick up on the first day of sessions.

Remember to list the program and date you are registering for, thank you.

Refund and Cancellation policy

2008 Spring & Summer Development Programs

Absolutely no refunds will be given, including a “no show” leaves on his own desire or has been expelled or dismissed for any misconduct. A credit note will be available in the event of an injury or illness with the proof of a Dr's medical certificate. NSF cheques or rescheduling will be subject to a $25.00 service charge.

2008 Fall/Winter Programs

Absolutely no refunds will be given, including a “no show” leaves on his own desire or has been expelled or dismissed for any misconduct. A credit note will be available in the event of an injury or illness with the proof of a Dr's medical certificate. NSF cheques or rescheduling will be subject to a $25.00 service charge.

Gear: Full gear is required, please bring water bottle

Xmas Camp Location: Planet Ice Delta (GPF) 10388 Nordel Court

Summer Camp Location: Planet Ice Delta (GPF) 10388 Nordel Court

Spring Hockey Location: Langley Twin Rinks, Sportsplex, Surrey Sport and Leisure & Planet Ice Delta (GPF)

Disclaimer We the applicant and his/her parents or legal guardians agree that Pacific Titans Athletic & Hockey Program, its owners, officers, employee’s, instructors, agents, coaches, supervisor’s along with the ice arena, recreational facility and their staff shall not be liable for nor held responsible for any incident or loss however caused and agree to release all mentioned parties from all claims and damages. I further verify that I am aware that my child will be participating in on/off ice sessions and at his/her own risk, and is in good health with No Medical Problems unless otherwise specified in writing. We further agree to be responsible for all medical and dental claims and/or insurance not covered.


 


Fields marked with*are required

Name : *
Email Address : *
Phone Number :
Parents/Guardians Name :
Mailing Address :
Postal Code :
Birth date :
Age :
Hockey (Rep or House) :
Years Playing :
Position played :
Program(s) Attending :
Date(s) :
Cost(s) :
Water Bottle Add $3.49 :
Please add 5% GST :
Method of payment :
Total Amount Payable :
TShirt Sz if applicable :
Jersey Sz if applicable :
Donot accept disclaimer :
Accept disclaimer :
I was referred by :
Please email programs :
Join our mailing list :
Message :