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Please contact via phone or email
Surrey .
British Columbia
Canada
Tel 604.574.0405 or 604.329.4775 or 604.785.0469
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Registration Form

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. Applicable taxes apply, please add 12% HST Cheque or Money orders made payable to: Pacific Titans Athletic Program mail to: 19002 60th Ave Surrey, BC V3S 7W4 Visa & Mastercard is accepted please call in with the type of card ie: Visa or Mastercard, name on card, card number & expiration date. PLEASE DO NOT EMAIL. 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. 

 Full gear is required, please bring your own water bottle

Refund and Cancellation policy - 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. 

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 :
Care Card # :
Hockey (Rep or House) :
Years Playing :
Position Played :
GPA if applicable :
Program(s) Attending :
Date(s) :
Cost(s) :
12% HST :
Cheque or Money Order :
Visa (Call in #) :
Mastercard (call in #) :
Total Amount Payable :
Donot accept disclaimer :
Accept disclaimer :
I was referred by :
Please email programs :
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Message :