Canadian Resident - DHA Registration

Financial Agreement*

I agree to fulfill the total program fee for my child's assigned team according to the payment schedule. Payment will be made to the Delta Wild Hockey Group by post-dated cheques, online payment, direct deposit or e-transfer. If an invoice is not paid when due, this could result in suspension of the student-athlete from ice time. If payments are outstanding for more than seven days, the family will be subjected to a flat rate administration processing late fee of $50. The Delta Hockey Academy reserves the right to treat unfulfilled payments as a breach of this agreement. If a player withdraws from DHA to play for a Junior A Tier 1 (Hockey Canada Sanctioned) or Major Junior (Hockey Canada Sanctioned) , he/she will not be obligated to fulfil the remainder of his/her monthly tuition instalments. If for any other reason, a player withdraws from DHA, you are obligated to fulfill the remainder of the monthly tuition instalments, unless otherwise agreed upon. 

The debit will be processed to your account on the 1st day of each month or the next business day. 

I/we authorize Delta Hockey Academy, and the financial institution designated (or any other financial institution I/We may authorize at any time) to begin deductions as per my/our instructions for monthly regular recurring payments and/or one time payments from time to time, for payment of all charges arising under my/our Delta Hockey Academy account(s). Regular monthly payments for the full amount of services delivered will be debited to my/our specified account on the 1st day of each month. This amount is determined by the team tuition for the given season registered for. Delta Hockey Academy will obtain my/our authorization for any other one-time or sporadic debits.

I may revoke my authorization and change payment method prior to the 1st payment of the 1st monthly, subject to providing notice of 14 days. To obtain a sample cancellation form, or for more information on my right to cancel a PAD Agreement, I may contact my financial institution or visit www.payments.ca.

I have certain recourse rights if any debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I may contact my financial instutition or visit www.payments.ca.

I understand that it is my responsibility to keep the team Saftey Person advised of any change in the above information as soon as possible. In the event of a medical emergency and that no one can be contacted, team management will arrange to take my child to the hospital or a physician if demed necessary. I hereby authorize the physician and nursing staff to undertake examination, investigation and necessary treatment of my child. I also authorize release of information to appropriate people.

For those who are new to DHA, the Delta Wild Hockey Group manages the Delta Health & Performance Clinic located at Planet Ice, Delta. It's an integrated sports medicine clinic with a team of healthcare practitioners dedicated to the highest standards of physiotherapy, chiropractic therapy, athletic therapy, massage therapy and mental performance training.

Should your son or daughter need additional care for an injury that occurs on the ice, you will be able to utilize healthcare coverage provided by Hockey Canada up $500 per player in a given season for physiotherapy and athletic therapy. Please note that if your child already has coverage through your own extended benefits plan, Hockey Canada requires that the family utilize that coverage first before the $500 will kick in. If your child is not covered for physiotherapy or athletic therapy under your family plan, then you can opt in to using the $500 coverage from Hockey Canada. Our medical staff will fill out the necessary Hockey Canada paperwork so that any expenses incurred by your family for physiotherapy or athletic therapy that is required in the recovery process will be reimbursed to you by Hockey Canada. 

You may skip the remaining questions if you are opting not to use our clinic services.