SUNIA Online Registration

Please complete the form below. Once you have completed the form, a green box will appear indicating that your registration has been sent. Upon receiving this green box, please click ‘Proceed to Payment’ to our payment page. Please note that the ‘Credit Card Holder Name’ refers to the name on the credit card which you will be using. This is required in order to match up the payments with the registration forms. Registrations will not be processed without their accompanying payments.

Student Information
Full Name:
Email:
Sex:  Male Female
Age:
Last grade completed by August 2012:
Address:
City/Town:
Province:
Postal code:
Telephone:
Health care insurance number:
Session choice:  Week A (Aug 12-17) Week B (Aug 19-24)
Taking bus from Red Deer:  Yes No
Health concerns:
(asthma, long-term medical conditions, current injuries, or anything else we may need to know in an emergency)
Dietary restrictions:
(vegetarian, other special diets, food allergies, etc.)

Credit Card Information
Credit Card Holder's Name:

School Information
School:
School address:
City/Town:
Province:
Postal code:
Telephone:

How did you hear about SUNIA?

Click the button below to proceed to the payment page! Registrations will not be processed without their accompanying payments.

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