MHA PAD Agreement

Please complete the Pre-Authorized Debit (PAD) Plan agreement below.

I/we authorize The Alberta Amateur Hockey Association, and the financial institution designated (or any other financial institution I/We may authorize at any time) to begin deductions as per my/our instructions for regular recurring payments (as denoted on the dates below) and/or one-time payments from time to time, for payment of all charges arising under my/our Alberta Amateur Hockey Association account.

If the authorized date falls on a Saturday, Sunday, or Holiday the full amount will be debited the following business day.

The Alberta Amateur Hockey Association will provide 10 days written notice of the amount of each regular debit. The Alberta Amateur Hockey Association will obtain my/our authorization for any other one-time or sporadic debits.

This authority is to remain in effect until The Alberta Amateur Hockey Association. has received written notification from me/us of its change or termination. This notification must be received at least ten (10) business days before the next debit is scheduled at the address provided below. I/We may obtain a sample cancellation form, or more information on my/our right to cancel a PAD Agreement at my/our financial institution or by visiting www.cdnpay.ca.

The Alberta Amateur Hockey Association may not assign this authorization, whether directly or indirectly, by operation of law, change of control or otherwise, without providing at least 10 days prior written notice to me/us.

I/we have certain recourse rights if any debit does not comply with this agreement. For example, I/we have the right to receive reimbursement for any PAD that is not authorized or is not consistent with this PAD Agreement. To obtain a form for a Reimbursement Claim, or for more information on my/our recourse rights, I/we may contact my/our financial institution or visit www.cdnpay.ca.

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PLEASE NOTE:

In the PAD Authorization section at the bottom of this form, the MHA is required to enter the name and email address of each of the authorized Account signers approving this agreement. Each authorized Account signer will receive an email that includes a secure link and password to access this document. In lieu of a formal signature, each signer is to fill out the required information to indicate his/her approval. Clicking SUBMIT will send the approval directly to Hockey Alberta

MHA PAD Agreement

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Required Fields *

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Member Information

Authorized Contact Name: *

Hockey Alberta Member Name: *

Type of Service: * PersonalBusiness

Address: *

City: *

Province: *

Postal Code: *

Phone - Business: * () - -

Phone - Residence: * () - -

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Financial Institution Information

Financial Institution (FI) Name: *

FI Account Number: *

FI Transit Number: *

Address: *

City: *

Province: *

Postal Code: *

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Debit Information

Team Fee Invoicing Payment Date: * November 15January 15March 15

Member Dues Payment (Full Amount) Date: * November 15January 15March 15

Initial Participant Invoicing Payment Date: * November 15January 15March 15

Year End Participant Reconciliation Invoicing Payment Date: * November 15January 15March 15

Upload DIrect Deposit Form:

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PAD Authorization

Authorized Signature 1 Name: *

Authorized Signature 2 Name: *

  Required for Form Submission

Please enter the email(s) for the following contact(s) in order to complete submission of this form:

Authorized Signature 1 Email: *

Authorized Signature 2 Email: *

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