C.O.E. COURSE REGISTRATION FORM
		www.coe.ca
		info@coe.ca	Box 7
		(403) 721- 2208	Nordegg AB
		Fax 1-888-314-3690	T0M 2H0
First Name:			Last Name:
Address:			Phone:
Address:			Fax:
Address:			Email:
Gender:			Shoe Size:
Name + Dates of Program to attend:
Describe any allergies or diet requirements including needs & severity, use separate sheet if necessary:
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How did you here about COE?
Registrations are confirmed only upon receipt of deposit with this completed form.
A deposit of 10% of total cost ($100 minimum) is required at the time of booking. Balance is due and payable 2 weeks prior to start of program.
If you cancel more than 4 weeks prior to course start, deposit will be returned minus a $50 admin fee. The COE will retain entire deposit if you cancel less than 4 weeks prior to program start date.
If you are using this form for Payment, please include the following: Please accept the following: Deposit____ Payment in full (due 2 weeks prior to course) ______ Check or money order ____ Visa ____ M/C ____ Name on the credit card: ________________________________________________________ Card Number_______________________________________ Card Expiry_______/________ Cardholder Signature __________________________________________________________ ***If you would rather speak to a COE representative to handle payment, please call 1-403-721-2208, or fax us your registration form 1-888-314-3690. E-mail is info@coe.ca. Mail: Box 7, Nordegg, AB, T0M 2H0. I ___________________________________ have read and agree with the above registration form.
I have also read and understand the above booking and cancellation policies.
Signature_______________________________________ Date: ____________________________