2025 Winter Registration

Registration Information

Welcome to the 2025 Winter Registration page.

Online Winter Program Registration Continues

Please scroll down and click on the left tab for program you would like to register for and complete the form.

All programs will be available for online registration after their registration night until the program is full.

Interested in Leading or Volunteering for a CHCA Program

Volunteer leaders can receive a CHCA Volunteer T-shirt.

Leaders of all programs must complete a RCMP criminal check.

Apply online at https://justice.gov.bc.ca/eCRC/home.htm Access Code: K27XV4CSLU

Please contact Jana at operations@collegeheightsca.org

CHCA ONLINE REGISTRATION INFORMATION

First come first serve basis. NO EARLY REGISTRATIONS. **Remember to refresh your screen at 7:00pm when Registration starts to see the links to the Registration Forms.**

Registration will continue while spaces are available. More programs may be offered if numbers warrant it. If you are on the waitlist, you will be contacted with new dates and times.

Registered participants only on the fields.

Stay in the specified program area.

Wear appropriate footware.

Be on time, as program is for a limited time.

Participants and Parents/Guardians of Minors must follow the CHCA Health and Safety Procedures.

Parents will be contacted to pick up unruly or ill children.

All programs subject to changes. Low enrollment or no leaders will cause cancellation.

Child’s proof of age is required for some programs. Medical waivers MUST be signed by the participant or the parent/guardian of a minor participant when registering for the program.

E-Transfer payable to CHCA at payment@collegeheightsca.org for each program is required.

Click on the Program to the left to for information and to register.

USE OF FACILITY

The CHCA would like to thank the various people who make the facilities available for programs.

This help is vital to the CHCA and we ask you to respect the following rules when attending our programs:

Drop-in Punch-card for 3 visits to Adult Programs $20 each, please email operations@collegeheightsca.org.

Registration will continue until a program is full.

Indoor Soccer 4-6 years

Indoor Soccer Wait List - Registration continues

4 - 6 Years. Please bring clean indoor runners. Parent participation is appreciated.

Southridge Elementary

Thursdays 6:15 pm - 7:15 pm January 23 - February 27

Registration is limited to 16. Leaders Needed.

$40.00 Registration Fee

Program Name Indoor Soccer 4-6 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Floor Hockey 6-8 years

Kids Floor Hockey Wait List - Registration continues

6 - 8 years. Please bring clean non-marking runners to program and some type of gloves is required. Sticks are provided.

Ecole College Heights

Tuesdays 6:30 pm - 7:30 pm January 21 - February 25

Registration is limited to 18. Leaders needed.

$40.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Floor Hockey 6-8 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Indoor Soccer 6-9 years

Indoor Soccer Wait List - Registration continues

6 - 9 years. Please bring clean indoor runners. Parent participation is appreciated.

Malaspina Elementary

Tuesdays 6:30 pm – 7:30 pm January 21 - February 25

Registration is limited to 16. Leaders Needed.

$40.00 Registration Fee

Program Name Indoor Soccer 6-9 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Lego Night 6-12 years

Lego Night Wait List - Registration continues

6 - 12 years. Be creative, build something new each week. Lego supplied.

Malaspina Elementary

Wednesdays 6:45 pm – 7:45 pm January 22 - February 26

Registration is limited to 16. Leaders Needed.

$40.00 Registration Fee

Program Name Lego Night 6 -12 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Floor Hockey 7-10 years

Kids Floor Hockey Wait List - Registration continues

7 - 10 years. Please bring clean non-marking runners to program and some type of gloves is required. Sticks are provided.

Malaspina Elementary Gym

Thursdays 6:30 pm - 7:30 pm January 23 - February 27

Registration is limited to 18. Leaders needed.

$40.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Floor Hockey 7-10 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Floor Hockey 9-12 years

Kids Floor Hockey Wait List - Registration continues

9 - 12 years. Please bring clean non-marking runners to program and some type of gloves is required. Sticks are provided.

Malaspina Elementary Gym

Thursdays 7:45 pm - 8:45 pm January 23 - February 27

Registration is limited to 12. Leaders needed.

$40.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Floor Hockey 9 -12 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Volleyball 9-12 years

Volleyball Wait List - Registration continues

9 - 12 years. Volunteer led volleyball for fun. Carry in clean indoor runners.

Southridge Elementary School

Wednesdays 6:00 pm – 7:00 pm January 22 - February 26

$40.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Volleyball 9-12 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Boys Basketball 9-12 years

Boys Basketball Wait List - Registration continues

9 - 12 years. This a beginner basketball program to learn basic basketball skills, play mini games & play on a different team each week. Carry in clean indoor runners.

Ecole College Heights

Wednesdays 6:30 pm – 7:30 pm January 22 - February 26

Registration limited to 16. Leaders Needed.

$40.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Boys Basketball 9 - 12 Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Mini-Chefs 10 years+

Mini-Chefs Wait List - Registration continues

10 years+ Fun course to start your child in the kitchen with basic techniques and meals.

Kool Cats Kid Care

Saturdays 10:00 am – 12:00 pm TBD

Registration is limited to 10. Leaders needed. Contact Jana at operations@collegeheightsca.org

$90.00 Registration Fee

Program Name Mini Chefs 10-12

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Can you help with coaching? Please select an option...Coaching

We will contact you if you are able to help with coaching.

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Home Alone 10 years+

Home Alone Wait List - Registration continues

10 years+. Teaches safety when home alone. Contains Basic First Aid and Fire Safety Component. All participants must be 10 years of age by the end of the program.

Kool Cats Kid Care

Sunday 10:00 am – 2:00 pm TBD

Registration is limited to 12.

~ If not able to attend please email Jana at operations@collegeheightsca.org at least 48 hours before day of class to reschedule. Additional classes will be offered if numbers warrant it.

$80.00 Registration Fee

Program Name Home Alone Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Red Cross Babysitting 11 years+

Red Cross Babysitting Wait List - Registration continues

11 years & up. This Red Cross course prepares boys and girls to become responsible babysitters. Learn how to care for babies, preschoolers, and school age children. Contains Basic First Aid and Fire Safety Component. All participants must be 11 years of age by the end of the program.

Kool Cats Kid Care

Sunday 9:30 am - 4:30 pm TBA

Registration is limited to 12.

~ If not able to attend please email Jana at operations@collegeheightsca.org at least 48 hours before day of class to reschedule. Additional classes will be offered if numbers warrant it.

$80.00 Registration Fee

Program Name Red Cross Babysitting Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Quilting 16 years+

Quilting - Registration continues

16 years+. Must have your own sewing machine. Bring your projects to finish off.

Kool Cats Kid Care

Mondays 7:00 pm - 9:00 pm January 6 - April 28 (except during Spring Break)

$50.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Quilting

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

Payment type Please select an option...

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.

Yoga 16 years+

Yoga Wait List – Registration continues

16 years+. Yoga for everybody. Bring a yoga mat and blocks if possible. We will practice awareness of the breath, mindful stretching, strengthening, fun balancing and relaxation.

Kool Cats Kid Care

Thursdays 6:15 pm - 7:15 pm January 16 - March 6

Registration limited to 12. No Drop-ins.

Instructor: Shauna Korogonas

$90.00 Registration Fee

Email Jana at operations@collegeheightsca.org for more information.

Program Name Yoga Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Badminton 16 years+

Badminton - Registration continues

16 years+. Volunteer led badminton for fun.

Southridge Elementary School

Wednesdays 7:30 pm - 10:00 pm January - April (TBD) (except during Spring Break)

$50.00 Registration Fee

Drop-in Punch-card 3 visits for $20

Limit 25.

Email Jana at operations@collegeheightsca.org for more information.

Program Name Badminton 16+

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

Payment type Please select an option...

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.

Volleyball 16 years+

Volleyball - Registration continues

16 years+. Recreational volleyball program but must have some volleyball experience.

Not a beginner program. Play on a different team each week.

College Heights Secondary

Wednesdays 8:15 pm - 10:00 pm January - April (TBD) (except during Spring Break)

$50.00 Registration Fee

Drop-in Punch-card 3 visits for $20

Registration is limited to 24.

Email Jana at operations@collegeheightsca.org for more information.

Program Name Volleyball 16+

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

Payment type Please select an option...

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.

Ladies Soccer 16 years+

Ladies Soccer - Registration continues

16 years+. Have some fun and exercise, with indoor soccer.

Southridge Elementary School

Tuesdays 7:00 pm - 9:00 pm January - April (TBD) (except during Spring Break)

$50.00 Registration Fee

Drop-in Punch-card 3 visits for $20

Registration limited to 18. Leaders Needed.

Email Jana at operations@collegeheightsca.org for more information.

Program Name Ladies Soccer 16+

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

Payment type Please select an option...

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.

Adult Volleyball 19 years+

Adult Volleyball Wait List - Registration continues

19 years+. Recreational volleyball program. Play on a different team each week.

Southridge Elementary

Thursdays 7:30 pm to 9:45 pm January 16 - April 24 (except during Spring Break)

$50.00 Registration Fee

Drop-in Punch-card 3 visits for $20

Registration limited to 16.

Email Jana at operations@collegeheightsca.org for more information.

Program Name Adult Volleyball Wait List

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

NO PAYMENT REQUIRED UNTIL REGISTRATION IS CONFIRMED AND YOU ARE CONTACTED.

Adult Floor Hockey 19 years+

Adult Floor Hockey - Registration continues

19 years+. Join us for recreational floor hockey. Plastic stick required. CLEAN, non-marking runners only.

Ecole College Heights

Tuesdays 7:45 pm - 9:45 pm January - April (TBD) (except during Spring Break)

$50.00 Registration Fee

Drop-in Punch-card 3 visits for $20

Registration limited to 18.

Email Jana at operations@collegeheightsca.org for more information.

Program Name Adult Floor Hockey

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury that may occur while

participating in this program.

Participant Electronic Signature Please check...

Date (YYYY-MM-DD) Please enter date

Payment type Please select an option...

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.

Drop In Punch Card

Drop In Punch Card

3 Visits to Badminton, Volleyball 16+ years, Adult Volleyball or Adult Floor Hockey

Fees: $20.00

Registration required in the above programs to attend.

Program Name Drop In Punch Card

Participant's Name Please enter participant's name

Age Age

Address Please enter address

Postal Code Please enter postal code

Email Please enter email address

Home Phone Please enter home phone number

Cellphone Please enter cellphone number

Emergency Contact Please enter information...

Phone Please enter phone number

Doctor’s Name Please enter information...

Phone Please enter phone number

Any health problems/allergies? Please enter information...

MEDICAL WAIVER: this certifies that Please enter participants name

Is in good health and is fully capable of participating.

In this program. I agree that sponsoring bodies shall not be liable for any injury

that may occur while participating in this program.

Parent or Guardian Electronic Signature Please check...

Parent or Guardian Name Please enter parent/guardian name

Date (YYYY-MM-DD) Please enter date

Please check... I will send an e-transfer payable to payment@collegeheightsca.org within 24 hours

of registering for this program or forfeit my registration. If unable to use e-transfer will email

Jana at operations@collegeheightsca.org to make other payment options.