Creative Wheel Consulting

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2011 Instruction

We are happy to offer online registration for select courses year. You must complete a form for every program participant.

Please note that ALL participants are requested to also fill the Canadian Cycling Association Waiver, Release & Indemnity form prior to program participation. Please bring the form filled and signed on the day of your program. Parent or legal guardian can bring their child's form on the Monday morning of camp. We will also have forms on site at all times.

If you wish to register by snail mail, you can complete this registration form and send with payment to:

Please include your Canadian Cycling Association Waiver, Release & Indemnity form in your mailout.

2011 Instruction

Choose a course for yourself or your family.

Participation in any of our programs or memberships requires payment of QST, GST, a $10 trail improvement fee and please purchase the OCA affiliation if you have not already done so. Riders without affiliation will not be allowed to participate.

June Co-Ed Training Camps:

Level (for above course):

Beginner Intermediate Advanced

$10.00

Trail improvement fee (mandatory).

$27.50

OCA Affiliation (non-taxable, per participant) You must be insured with our club insurance to participate to a mountain bike program. This is a one time fee.

REFUNDS:

All fees are non-refundable except with a physician's certificate. If you are registrating by snail mail, we accept $200 deposit along with post-dated payment of balance no later than 2 weeks prior to the start of session being attended. Minimum of 25 campers per week is required to run a session.

Contact

Please indicate how to contact you. You must provide telephone contacts, in case of emergency.

NOTE when entering a phone number, common formats are accepted. Some examples:

613 123 4567
(613) 123-4567
613-123-4567 x8910

Home #

Work #

Emerg. #

Email (Re-Type)

Street Address 1

Street Address 2

City

Province

Country

Postal Code

Your personal and address information will not be shared with any third party without your prior concent. We do not store credit card information of any kind on our web site.

Medical Information

It is of critical importance that you advise us of any medical issues that might put you to risk during your participation. Please call us at 613.820.1919 if you have any allergies to insects (bees, wasps, hornets, spiders). All information is kept strictly confidential.

Release Waiver

I am aware of the inherent risks of bodily injuries and material damages possibly involved in the practice of this outdoor sport activity. I will follow the safety guidelines recommended in order to prevent any accident to myself and/or to the other participants. I hereby state that I am in good mental and physical health and I am not afflicted by any handicap that may endanger my participation in the activities proposed. Having registered for the above program, I hereby authorize LaRoccaXC Mountain Bike School and Club / Creative Wheel Consulting Inc. director and all of her appointees, volunteers and instructors, in the event of accident or illness affecting the above registered, to authorize on my behalf all procedures, including admission to hospital and necessary treatment therein, as deemed essential for the care and well-being of myself. Such action is to be taken only when immediate contact with myself, or emergency contact listed above, cannot be made. I understand that the pictures/videos/slides taken at the camp may be used for promotion. I have read and understood the refund policy and understand clearly that LaRoccaXC MTB Club / Creative Wheel Consulting Inc. will not be held responsible/liable for any lost, stolen or damaged belongings/sport equipment used by myself during my participation in the program.

I Agree to the terms and conditions.

Click the Register Now button to proceed to online payment.

	Year:	Month:	Day:
Date of Birth:				Male Female

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2011 Instruction

2011 Instruction

June Co-Ed Training Camps:

Participants

Participant #1 (primary contact)

Participant #2

Participant #3

Participant #4

Participant #5

Contact

Medical Information

Release Waiver

NEWS