HCSA SOUTH SURREY
CONTACT INFORMATION :

HCSA Coordinator : Mike Coflin
Email: coflin_m@sd36.bc.ca
Contact Number: 604.531.8354

EARL MARRIOTT SECONDARY
Website : www.earlmarriott.com
Principal : Mr.P. Johnston
Teacher : Mr.M. Coflin
Contact Number : 604.531.8354

ELGIN PARK SECONDARY :
Website : www.elginpark.net
Principal : Mr.K.Deboice
Teacher : Ms. A. Thomson
Contact Number : 604.538.6678

SEMIAHMOO SECONDARY :
Website : www.semi.sd36.bc.ca
Principal : Ms. B. Hadikin
Teacher : Mr. T. Lescisin
Contact Number : 604.542.5258

HOCKEY CANADA
Website : www.hockeycanada.ca

HOW TO MAKE A CLAIM

1. SECURE a Hockey Canada Accident Report Form from your team or Minor Hockey Association. In the event that there are none available, download the file from Resources section of the BCAHA website www.bcaha.org
2. COMPLETE the form in its entirety. Have your team official complete the team section and your Doctor/Dentist complete the back of the form.
3. SUBMIT the fully completed form to your Branch office along with any receipts or invoices within 90 days of the date of accident.

NOTE:
- only Accident Report Forms received in the Branch office within 90 days of the date of accident will be accepted.
- forms must be completed in their entirety or the forms will be returned.
- only original receipts and/or invoices are acceptable.
- Hockey Canada is strictly a supplemental insurer. If you have access to any other insurance, you must pursue it through them first. Hockey Canada shall cover those costs not covered by your primary insurance to our policy limits.

DOWNLOADS

Please click on the following link to download the forms.

BC Hockey Injury Report Form