ONLINE REGISTRATION

• The information below will be forwarded to the Dragon Zone Coordinator.
• Once your registration has been processed, you will receive an Individual Membership Form and a Waiver for your team. These must be filled out by each member of your team and submitted by your first practice in 2010.
• Payments are processed via PayPal. You DO NOT need a PayPal account to use your credit card on their network.
• All fields are required, unless preceded by a blue asterisk symbol * .

A. TEAM INFORMATION

Team Name:
Mgr. First Name:
Mgr. Last Name:
Address 1:
* Address 2:
City:
Province:		British ColumbiaAlbertaManitobaNew BrunswickNewfoundlandNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon
Postal Code:
Day Phone:
Evening Phone:
Email:
* Email #2:

B. PACKAGE INFORMATION

Category:		Adult	Junior	Senior
Package:		Jan-Dec	Jan-Jun	Jul-Sep
Frequency:		1 per week	2 per week	3 per week

C. PRACTICE LOCATION, DAYS & TIMES

Preferred practice location:
		False Creek, Vancouver (original location) Fraser River, Richmond (new location)
Start Date:		YYYY 2010-MMM Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec-DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Please select your practice frequency above, first.

Practice #1:

Select Day MondayTuesdayWednesdayThursdayFridaySaturdaySunday   Select Time 4:30 pm6:00 pm7:30 pm8:30 am10:00 am11:30 am

Practice #2:

Select Day MondayTuesdayWednesdayThursdayFridaySaturdaySunday   Select Time 4:30 pm6:00 pm7:30 pm8:30 am10:00 am11:30 am

Practice #3:

Select Day MondayTuesdayWednesdayThursdayFridaySaturdaySunday   Select Time 4:30 pm6:00 pm7:30 pm8:30 am10:00 am11:30 am

D. DAMAGE DEPOSIT & PAYMENT OPTIONS

RETURNING TEAM? Is your team returning from last season?
		Yes, returning	No, we're a new team

DAMAGE DEPOSIT For Returning Teams: Do you wish to roll over your damage deposit from last season? For New Teams: A damage deposit of $150 is required and will be added to your order.

Yes

No

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