Registration - Hockey Institute

Skating Coach Certification Registration

Please fill in the form completely. The reason we are asking for a physical address is because after successful completion of the course, a certificate will be mailed to you by Mike Bracko.

Payment is through PayPal. After submitting the form, you will be redirected to PayPal. After successfull payment , you will be redirected back to the website and will be able to login with the provided credentials.

Name

Provide your name.

Provide your email.

Verify Email

Provide your email, please ensure it is typed corerctly.

Password

Please provide a password, ensure it is complex enough so that it cannot be easily guessed.

Verify Password

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Address 1

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Address 2

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City

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Province

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Country

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Postal Code

Please provde a postal code.

Certification Program Price

Certification Program Price - 122.00 CAD

Total

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