Individual Registration

Please enter information in the form below to process registration for event HCC Winter Junior Learn to Curl Program.

First Name *

Last Name *

Address *

Address 2

City *

Postal Code/Zip *

Phone *

Contact Email *

Comment

Junior Member Full Name *

Junior Member Age *

Junior Member Experience *

None

Has tried it a few times

1 year or less

More than 1 year

Parent/Guardian Name *

Amount

Tax Amount

Gross Amount

Payment Method *

Online Payment (Credit Card) Offline Payment - E-transfers sent to [email protected].

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

Captcha*

948 South Bland Street
Halifax, NS
B3H 2S5

Phone: 902-423-7857
Fax: 902- 423-4323
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