Beginner (9am-12pm) - Individual Registration

Contact Email (please ensure it's correct!) *

Contact phone (preferably cell) *

Participant's First Name *

Participant's Last Name *

Participant is under age 18? *

No

Yes

Your full name (if not participant)

Address

City *

Postal Code *

Province

Referral source (where did you hear about us?) *

Additional Project 529 shields ($7.50+GST each)

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No

Yes

Would you like a receipt? *

Yes

No

Coupon

Amount

$

Discount Amount

$

Tax amount

$

Gross amount

$

Payment Method *

Paypal / Credit Card Email Money Transfer

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

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Individual Registration