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COURTENAY RECREATION

| 250-338-5371 | 250-338-1000 |

courtenay.ca/rec

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COURTENAY

REGISTRATION

96

Total Fees:

$________________+5%GST

(if over 14 yrs)

: $___________

= TOTAL:

$_______________

Payment:

(Must be includedwithyour registration)

( )Cheque ( )Visa ( )MC Cardholder’sName:______________________

Credit Card#: _______________________________________________________

ExpiryDate:________________Phone#: _______________________________

Name: _________________________________________________________

B i r thda t e : _ _ _ _ _ _ _ _ _ _Care Card#_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

A l l erg i es /Med i ca l Cond i t i ons : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Address: _________________________________________________

City:________________________Postal Code:___________________________

HomePhone:

_____________________________________________

A l t e r na t e Phone : _ _ _ _ _ _ _ _ _ _ _ _ _ _ Ema i l : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Participant’sName:

_________________________________________

Program: ___________________________________________________

Time: _______________ StartDate: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Bar code#___________________________ProgramFee: $_________________

Participant’sName:

___________________ _____________________

Program: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Time: _________________Start Date:______________________

Bar code#____________________ProgramFee: $_________________

Registration Information

Fall Program Registration

begins

Monday August 15

at 7:15 am

In Person

At the Lewis Centre or

the Filberg Centre

By Phone

250-338-5371 or 250-338-1000

Use your Visa or Mastercard

By Fax

250-338-8600

Lewis Centre

250-338-0303

Filberg Centre

Fax registration (this page)

Use your Visa or Mastercard

By Mail

Mail registration form (this page)

with payment to:

Lewis Centre

, 489 Old Island Hwy

Courtenay, B.C. V9N 3P5

Filberg Centre

, 411 Anderton Ave

Courtenay, B.C. V9N 6C6

Sign me Up!

Registration Policy

• All registrations areprocessedonafirst comefirst serve basis.

• Pre-registration is required for all classes exceptwhenspecifiedas

adrop-inclass.

• Fees are tobepaid in full at the timeof registrationby cash, cheque,

Visa,MastercardorDebit Card. Pleasemake chequespayable to

theCityof Courtenay.

• Registration is limited to the immediate familyplusmembers from

oneother familyonly. Some restrictionsmayapply.

• CourtenayRecreation reserves the right tomake cancellationsor

changes asnecessary.

• G.S.T.will be chargedonall programswithparticipantsover the

ageof 14andonall fieldand facility rentals. Programparticipants

14years andunder arenot subject to tax, with theexceptionof all

drop-inprograms. Someexceptionsmayapply.

• A$20handling chargewill be collectedonN.S.F. cheques.

• Please readconfirmation receipts carefully for informationon

dates, times, supplies, etc.

4 easy ways to register for

Courtenay Recreation programs!

Refunds

• A full or pro-rated refundwill begiven

if a class is cancelled, or formedical

reasonswithadoctor’snote.

• All requests for refunds, creditsor

transferswill beprocessedwitha full

refundup toFIVEdaysbefore the start

of theprogram. After this time, anad-

ministrative feeof $5will be charged

onall cash, Visa,MastercardandDebit

Card refunds.

• Pleaseallowup to3weeks for cheque

refunds tobeprocessed.

• Pro-rated refundswill beprovided

after thefirst class, basedon thedate

of notification.

• Pleasenote theremaybeexceptions

to thispolicy (eg. CozyCorner Pre-

school, programsof short duration,

workshops, etc.).

• Refundswill not beapprovedafter a

programhas ended.