Reimbursement Request Form

Please complete the form and submit it no later than November 30, 2022 to the Recreation Department at:

Type of membership

First Name

Last Name

SN Number

Write N/A for retiree or any other type of member

Family member

All family members must be PSP Plan members and provide proof of address.

Proof of address (family)

Please select a file

Date of birth

DD/MM/YYYY

Home Address

City

Province

Postal Code

Telephone

Secondary phone

Proof of payment

Please select a file

Registration fee

Payment receipt

Please select a file

Proof of participation

Please select a file

Results

Privacy Notice

I confirm that I have read the PRIVACY NOTICE.

Consent Agreement

By registering to this program or activity, I consent to the collection and use of my personal information as described in the privacy notice above.

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