ICS Course Registration

Select Course and Date(Required)

Delegate Name(Required)

First Last

Delegate Email(Required)

Parent/Guardian/Carer Email

(if delegate is under 18 years of age)

Address of Residence(Required)

Street Address City Province Postal Code

Date of Birth(Required)

(MUST BE 15 YEARS OF AGE OR OLDER TO TAKE COURSE)

YYYY

Gender Identity(Required)

Male

Female

Other

Prefer not to say

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Date of Birth – OLD

(MUST BE 15 YEARS OF AGE OR OLDER TO TAKE COURSE)

YYYY

Club(Required)

(Type n/a if not working with a club)

Learning Accommodations

(Accessibility, visual aids, etc.)

Medical Information (Allergies, etc.)

Emergency Contact Name(Required)

First Last

Emergency Contact Phone Number(Required)

Emergency Contact Relationship to Delegate(Required)

I confirm that the information provided including my province of residence is accurate & I understand that registration fees vary by province.(Required)

I Confirm

ICS Teacher Training Course(Required)

Processing Fee

Price: $ 0.00 CAD

GST

Price: $ 0.00 CAD

Total

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ICS Course Registration

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