Tournament Travel Permit/Cheque Request (Burlington City Rep Hockey Club)

Print Tournament Travel Permit/Cheque Request

Once this form has been submitted, a Cheque and Travel Permit will be processed for your Tournament. You will be emailed a copy of the approved Travel Permit once OMHA has processed it.

Team Name^*
Your Name^*
Email^*

Your submission will be sent to this address for confirmation.
Travel Permit Type:^*
Tournament Name^*
Location^*
Sanction Permit #:^*

Please find the Sanction Permit # on the tournament's website.

Date From:^*

Open the calendar popup.

To:^*

Open the calendar popup.

Cost of Tournament^*

Tournament Payment Information

See Tournament Deposit section below if deposit reimbursement required.

Amount of Payment^*

This should be the balance of the cost of the tournament if a deposit has already been made
Funds^*
CDNUS
Make Cheque Payable To:^*
Mailing Address: Street^*
City, Province^*
Postal Code^*
If payment for a tournament is being paid by personal credit card, please scan and attach Proof of Payment.

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
Maximum # Files: 2. Maximum File Size: 4MB.

Tournament Deposit Payment Information If Applicable

Please complete this section ONLY if you are looking for reimbursement for a Tournament Deposit that was made by the team.

Amount of Deposit
Make Cheque Payable To:
Mailing Address: Street
City, Province
Postal Code
Please scan and attach Proof of Payment if a Deposit has been made by the team.

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx, .xls, .xlsx, .ppt, .pptx.
Maximum # Files: 2. Maximum File Size: 4MB.