BCHL Credit Card Payment Form (Brantford Community Hockey League)

Print 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^*

Open the calendar popup.

Contact Information

Name of Parent or Guardian^*

First and Last Name
Main Phone Number^*

eg. ###-###-####
Email Address^*

Your confirmation email will be sent to this address.

Payment Information

Select Division Fee^*
Card Type^*
VISAMASTERCARD
Card Number^*
Expiry Date^*
Security Code^*

Number found on back of card
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.

Human Validation

Check The Box ^*

BCHL Credit Card Payment Form (Brantford Community Hockey League)

Get Mobile!

Contact Us