SSAC Summer Camp Credit Card

This form is only for previous registrants that have been notified to make credit card payment.
You have already completed long form. If not, proceed to registration form at SSAC Summer Camp

Player - First Name *

First Name - Title Case, e.g. Connor

Player - Last Name *

Last Name - Title Case, e.g. McDavid

Email *

Contact Email Address

Phone *

000-000-0000

U13 PEEWEE PROGRAMS

Please enrol me
for this session

A) U13 Peewee - 2 Week Package @ $500 *** Early Bird $450 ***
Week 1 August 17-21 @ Kenilworth Arena 16:45 - 18:00
Week 2 August 24-28 @ Kenilworth Arena 16:45 - 18:00

A1) U13 Peewee - 1 Week @ $275
Kickoff Week August 10-14 @ Callingwood A/B Arena
Mon-Tue 16:45-18:00, Wed 15:45-17:00, Thu 17:30-18:45, Fri 17:00-18:15

A2) U13 Peewee - 1 Week @ $275
Week 1 August 17-21 @ Kenilworth Arena 16:45 - 18:00

A3) U13 Peewee - 1 Week @ $275
Week 2 August 24-28 @ Kenilworth Arena 16:45 - 18:00

Total Payment $

Fee as per selected rate checkbox above

U15 BANTAM
PROGRAMS

Please enrol me
for this session

B) U15 Bantam - 2 Week Package @ $500 *** Early Bird $450 ***
Week 1 August 17-21 @ Kenilworth Arena 18:15 - 19:30
Week 2 August 24-28 @ Kenilworth Arena 18:15 - 19:30

B1) U15 Bantam - 1 Week @ $275
Afternoon Week August 10-14 @ Callingwood A/B Arena
Mon-Tue 15:15-16:30, Wed 14:15-15:30, Thu 16:00-17:15, Fri 15:30-16:45

B2) U15 Bantam - 1 Week @ $275
Week 1 August 17-21 @ Kenilworth Arena 18:00 - 19:15

B3) U15 Bantam - 1 Week @ $275
Week 2 August 24-28 @ Kenilworth Arena 18:00 - 19:15

U18 MIDGET
PROGRAMS

Please enrol me
for this session

D1) U18 Midget - 3 Week Package @ $650 *** Early Bird $600 ***
Week 1 August 17-21 @ Kenilworth Arena 21:15 - 22:45
Week 2 August 24-28 @ Kenilworth Arena 21:15 - 22:45
Week 3 August 31-September 4 @ Kenilworth/TBA Arena
1st Session 19:30 - 21:00 / 2nd Session 21:15 - 22:45
Select 3 week preference combination from Week 1, 2, 3 options below

D2) U18 Midget - 2 Week Package @ $500 *** Early Bird $450 ***
Select 2 week preference combination from Week 1, 2, 3 options below

D3) U18 Midget - 1 Week Package @ $275
Select 1 week preference from Afternoon & Week 1, 2, 3 options below

2 Week Package

Select 1 Box:
Week 1 & 2
Week 1 & 3
Week 2 & 3

Week 1 & 2 Package
Week 1 August 13-17 @ Confederation Arena 21:00 - 22:30
Week 2 August 20-24 @ Confederation Arena 21:30 - 23:00

Week 1 & 3 Package
Week 1 August 13-17 @ Confederation Arena 21:00 - 22:30
Week 3 August 27-31 @ Confederation Arena 20:45 - 22:15

Week 2 & 3 Package
Week 2 August 20-24 @ Confederation Arena 21:30 - 23:00
Week 3 August 27-31 @ Confederation Arena 20:45 - 22:15

1 Week Package
Select 1 Box:
Week 1, 2 or 3

D3) Afternoon Week August 10-14 @ Callingwood A/B Arena
Mon-Tue 15:00-16:15, Wed 12:45-14:00, Thu 14:30-15:45, Fri 14:00-15:15

D3.1) Week 1 August 17-21 @ Kenilworth Arena 21:15 - 22:45

D3.2) Week 2 August 24-28 @ Kenilworth Arena 21:15 - 22:45

D3.2.2) Week 2 August 24-28 @ Meadows West Arena
Mon 17:00-18:15, Tue-Thu 16:15-17:30, Wed-Fri 16:30-17:45

D3.3) Week 3 August 31-September 4 – 1st Session
Mon 19:30-21:00 Kenilworth, Tue 19:45-21:15 Kinsmen A
Wed 18:45-20:15 Kenilworth, Thu 19:15-20:30 Terwillegar B
Fri 18:00-19:15 Kinsmen B

D3.4) Week 3 August 31-September 4 – 2nd Session
Mon 21:15-22:45 Kenilworth, Tue 21:30-23:00 Kinsmen A
Wed 21:00-22:15 Terwillegar D, Thu 20:30-22:00 Meadows East
Fri 19:30-20:45 Kinsmen B

D3.5) Week 3 August 31-September 4 – 3rd Session
Mon 17:45-19:15 Mill Woods A, Tue 20:30-22:00 Terwillegar B
Wed 19:30-20:45 Terwillegar D, Thu 20:45-22:00 Terwillegar B
Fri 20:15-21:45 Meadows East

Final Payment $

Fee as per selected rate checkbox above

Credit Card - First Name *

First Name - Capital first letter Title Case, e.g. John

Credit Card - Last Name *

Last Name - Capital first letter Title Case, e.g. McDonald

Address

e.g. 11100 - 123 Street NW

City

Province

Postal Code e.g. T6T 1E1

Complete Street Address, City, Province, Postal Code

Credit Card *

Credit Card Number - MasterCard / Visa / AMEX

Expiry Month

Expiry Year

CVC

South Side Athletic Club

Elite AAA/AA | U13 | U15 | U16 | U18

SSAC Summer Camp Credit Card