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Western Canadian Referee School
Registration
Register me for the Meal Program 
Register me for the Early Registration - Carry Over Rate $299
First Name
Last Name
Age
Phone Number
Emergency Contact #
Email Address
Minor Hockey Affiliation
Postal Code
Province
Address
City
# of Years Officiating
Highest Level Officiated
Dietary Concerns: If you answered yes to the Meal Program, please indicate if you have any dietary concerns:
"I had a lot of fun and the school helped me improve my skills as a referee and linesman."
                        Student, 2015
PAYMENT OPTIONS:
If an association is not sponsoring your registration:

*NEW Pay by eTransfer: 
If you would prefer to pay by etransfer, please contact Trevor at tboudreau@shaw.ca.

Pay by Cheque:
Please make your cheque payable to:
Western Canadian Referee School

Mail payment it to:
13857 Silver Valley Road
Maple Ridge BC 
V4R 0C2

*Payment must be received within 30 days of registration.
Is an Association sponsoring your registration?
If yes, which Association?
*Please note that Internet Explorer may not work with this form. For best results please use Google Chrome or Firefox.  We apologize for the inconvenience.
YesNo
Yes
YesNo