Please complete this registration form to register for the CSIA Atlantic Fall Convention at Mont-Ste-Anne on December 12, 13, and 14, 2009.
Last name First name Member number Ski area CSIA certification Select your CSIA certification CSIA Level I CSIA Level II CSIA Level III CSIA Level IV CSCF certification Select your CSCF certification CSCF Level I CSCF Level II CSCF Level III CSCF Level IV Mailing address City Province Postal code Phone number Email
Last name
First name
Member number
Ski area
CSIA certification
CSCF certification
Mailing address
City
Province
Postal code
Phone number
Email
Select a ski clinic from the list (one only): Select a clinic CSIA general ski improvement CSIA Level II preparation CSIA Level III course preparation CSIA Level III exam preparation CSIA Level IV preparation CSIA Level 1 course conductor training CSCF general ski improvement Please indicate if you will be participating Monday AM What is your preferred language for your clinic? Select language English French
Select a ski clinic from the list (one only):
What is your preferred language for your clinic?
You can purchase your lift tickets through the CSIA Atlantic for two or three days (the ski clinic on the third day is optional), or you can get your own lift tickets.
From the list, select your lift ticket option.
Select a lift ticket option for your friend.
Your registration is not complete until we receive your payment.
Your total payment is:
Number of participants x $300* + lift tickets ( + ) x $35/day = Total of $
Select a payment option.
I will mail a cheque for the amount above. Make cheques payable to CSIA Atlantic and mail to: Perry Humphries Treasurer, CSIA Atlantic 31 Washington St. Corner Brook, NL A2H 1K4 I will pay through PayPal (with my credit card or PayPal account). If you select this option click here before submitting this form to purchase via PayPal. The PayPal form will open in a new window, please disable any pop-up blockers.
*Early bird Price. $250 for CSIA Atlantic Members registering before November 30, 2009. Cheques must be received by December 2, 2009 to receive this benefit. Persons registering after November 30, 2009 will be charged the regular rate of $300.
