Fédération de voile du Québec

Payement and Recap

Boat driving course

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$

Boat Safety Course Fee

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$

Total

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I have read and accept the terms in the Equipment User Contract(*)

Yes

Please read and accept before submitting

Terms and conditions - French only

Please check to agree(*)

I have carefully read the schedule and will be present
for all the courses I have registered for.
I am aware that no refund will be given for
registered courses except for a major reason.

Please check to accept the conditions

Please check to agree.(*)

I realize that I have to send a copy of all my prerequisites to the FVQ
prior to the clinics. Otherwise, I will not be allowed to attend the clinic
and no refund will be made.

Please check to accept the conditions

Newsletter

I agree to receive the newsletter from the FVQ

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Payement

Payer email(*)

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We need the email adress of the person that will pay the registration fees.

Payment mode(*)

Cheque
VISA
MASTERCARD

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Name on Credit Card

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Credit Card Number

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No spaces in between number

CVV

Donnée invalide

Code à trois chiffres derrière la carte

Card expiry date

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Acknowledgement

I accept that the 250$ deposit will be cashed on this credit card in case that the candidate is responsible for damages.

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Please send us a second cheque for the $250 deposit. It will only be cashed in case of damages for which the candidate is responsible, and will otherwise be destroyed after the clinic.

(Should you rather not give your credit card number on this form, please call our office at 514-252-3097 to give it to us over the phone.)

Please copy the text to help us reduce the spam(*)

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	*Hi and welcome on the Registration form for 2018 Boat Safety Courses!* Before you begin : First, you may check the timetable and course schedule; Remember that you must have your PCOC to attend the course and be over 14; Also, we would like to inform you that a 250$ deposit is required for all on board clinics, including the Safety Boat Course. The deposit will only be cashed in case of damages. If you have any difficulties with your registeration, don’t hesitate to contact us at formation@voile.qc.ca or to call us on 514-252-3097.

	Personal Information
First Name(*)	Invalid Input
Last Name(*)
Date of Birth(*)	Invalid Input	YYYY-MM-DD
Email address(*)
Home Phone Number(*)	Invalid Input
Mobile Phone Number	Invalid Input
Address(*)	Invalid Input
City(*)
Province	Invalid Input
Postal Code(*)	Invalid Input
Club / School (complete name)	Donnée invalide
Emercency Contact Name	Invalid Input
Emergency Contact Phone Number
Prefered Language	Invalid Input
Allergies or other conditions	Invalid Input
What is your Adult T-Shirt Size?	Donnée invalide

	Course selection
Do you want to follow a boat driving course ?	Invalid Input	Prior to attend the boat safety course, it is mandatory to have a five hour experience in driving a motor boat.If you don't, please select a course.
Choose the date of your boat driving course	Invalid Input
Would you like to follow a Boat Safety course?	Invalid Input
Which level?	Invalid Input	*Only instructors who have already followed the boat safety course can register for the re-certification.
Which date would you like to do your Boat Safety Recertification?	Donnée invalide
Select your dates for the Boat Safety course	Invalid Input	For the courses with the new Timetable, candidates will have to attend an online course (2h30) before joining the practical course. Details and schedule will be given about a month prior to the course itself.
Do you have your PCOC (Pleasure Craft Operator Card)?	not yetyes Invalid entry
Select the issuing date of your PCOC	Invalid entry
If you have not yet sent us a copy of your PCOC, please dowload it here.	Max File Size is 500 ko !	Please name your file as follow: name_firstname_PCOC File must be < 500 Ko

	Payement and Recap
Boat driving course	Invalid Input	$
Boat Safety Course Fee	Invalid Input	$
Total	Invalid Input
I have read and accept the terms in the Equipment User Contract(*)	Yes Please read and accept before submitting	Terms and conditions - French only
Please check to agree(*)	I have carefully read the schedule and will be present for all the courses I have registered for. I am aware that no refund will be given for registered courses except for a major reason. Please check to accept the conditions
Please check to agree.(*)	I realize that I have to send a copy of all my prerequisites to the FVQ prior to the clinics. Otherwise, I will not be allowed to attend the clinic and no refund will be made. Please check to accept the conditions
Newsletter	I agree to receive the newsletter from the FVQ Invalid Input
	Payement
Payer email(*)	Invalid Input	We need the email adress of the person that will pay the registration fees.
Payment mode(*)	Cheque VISA MASTERCARD Invalid Input
Name on Credit Card	Invalid Input
Credit Card Number	Invalid Input	No spaces in between number
CVV	Donnée invalide	Code à trois chiffres derrière la carte
Card expiry date	Invalid Input
Acknowledgement	I accept that the 250$ deposit will be cashed on this credit card in case that the candidate is responsible for damages. Invalid Input
	Please send us a second cheque for the $250 deposit. It will only be cashed in case of damages for which the candidate is responsible, and will otherwise be destroyed after the clinic.
	(Should you rather not give your credit card number on this form, please call our office at 514-252-3097 to give it to us over the phone.)
Please copy the text to help us reduce the spam(*)	Invalid Input

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