BCHL Credit Card Payment Form (Brantford Community Hockey League)
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BCHL Credit Card Payment Form
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BCHL Credit Card Payment Form
Please complete this form if you wish to pay for your registration fees by Credit Card. Alternately, you can pay by ETRANSFER to
[email protected]
- PLEASE INCLUDE PLAYERS NAME IN THE MESSAGE PORTION OF THE EMAIL TRANSFER. ***THIS IS A SECURE FORM AND INFORMATION WILL NOT BE SHARED OR SAVED***
Player Information
Player Name
*
First and Last Name
Date of Birth
*
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Contact Information
Name of Parent or Guardian
*
First and Last Name
Main Phone Number
*
eg. ###-###-####
Email Address
*
You will NOT receive confirmation of this form for security of personal information..
Payment Information
Select all items you are submitting payment for
Select Division Fee
*
Little Saints $150
U6 and U7 Tyke $375.00
U8 and U9 Novice $395.00
U10 and U11 Atom $475.00
U12 and U13 Peewee $475.00
U14 and U15 Bantam $475.00
U16 to U21 MID/JUV $375.00
ALL GOALIES $100.00
IP Select Development Oct - Dec $80.00
Atom Select $400.77
Peewee Select $306.47
Bantam Select $350.00
Midget Select $235
Select Jerseys $100.00
Select Socks $25.00
OVERDUE SEASON FEES - MARK AMOUNT IN COMMENT BOX
Check All That Apply
Card Type
*
VISA
MASTERCARD
Card Number
*
Expiry Date
*
Are you paying for multiple players?
List names of all players you are making payments for
Outstanding Season Fees
Please write in FULL AMOUNT or PARTIAL PAYMENT and the amount you wish to pay.
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