HCA 2019/2020 Registration Form
Please note until payment is received, registration is not complete. An HCA Admin member will follow up with each registration to confirm receipt of form, payment method, and payment breakdown. If you have any questions, please email
or call 905-528-4020.
Full Course Name (as listed on Website)
New or Returning Student?
Student Date of Birth
Grade Entering in School (if applicable)
Parent/Guardian Name (if applicable)
Full Address (Street, City, Postal Code)
Main Phone #
Alternate Phone #
Please list any student medical conditions/allergies/behavioural concerns
There are times when the media runs stories of the activities we have at HCA, or we like to take photographs/video to be kept on file, and used in duture promotional and/or informational brochures, posters, newsletters, web pages, and advertisements for HCA and other related publications. Do you give consent for the student to be photographed or video taped?
Monthly Post-dated Cheques (dated for the first of each month, September 1 - June 1)
Term Post-Dated Cheques (dated for September 1, December 1, March 1)
Monthly Pre-authorized Credit Card - VISA or MC (adds 3% to tuition)
Term Pre-authorized Credit Card - VISA or MC (adds 3% to tuition
Pay in Full with Debit, Cash, or Credit Card
A copy of your responses will be emailed to the address you provided.
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