Applicants information
See below if registering more than one applicant for your facility
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Facility's Information
Facility Name
*
Facility Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Facility/Organization Name
Facility Name
Short name
Name of Facility/Organization Contact
First Name
Last Name
Phone Number and Email of Contact
Phone Number
email address
How many participants are you registering?
*
Please Select
1
2
3
Please enter names and contact information of each participant below.
Additional Applicants Information
If you are registering more than ONE participant, please fill out the below.
Second Applicant's Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Third Applicant's Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Phone and Email
Phone Number
Email address
Participants #2 Phone and Email
Phone Number
Email address
Participants #3 Name
First Name
Last Name
Participants #3 Phone and Email
Phone Number
Email address
Participants #3 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is this your first time attending?
*
Please Select
Yes
No
How did you hear about the Arena Level 1 & Ice Maintenance Combined Course?
*
Are you a MEMBER of RFANS:
*
Please Select
Member
Non-Member
Would you like to become a MEMBER of RFANS:
*
Please Select
Please contact me
Do not contact me
Date
-
Month
-
Day
Year
Date
How would you like to pay?
*
Master Card
Visa
American Express
PayPal
Invoice
Method of Payment
MasterCard
VISA
American Express
Paypal
Other
My Products
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Arena Level 1 & Ice Maintenance Member Fee
$
600.00
CAD
Quantity
1
2
3
Item subtotal:
$
0.00
CAD
Arena Level 1 & Ice Maintenance Non-Member Fee
$
700.00
CAD
Quantity
1
2
3
Item subtotal:
$
0.00
CAD
Submit
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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