SSJ Arena - Public Access

Notice: To make payment on an invoice online with a credit card,

Step 1. Create Billing Contact

Step 2. Activate Account

Step 3. Account Activated

Contact Information Note: Red text indicates required fields.

Billing First Name:

Billing Last Name:

Address 1:

Address 2:

Country:

Prov/State:

City:

Postal/Zip Code:

Phone 1:

Phone 2:

Email:

Alternate Email:

Client #:

Account Information

Username:
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Password:

Re-Type Password:

Password Strength

Note: For the best Password Strength rating include:

Extra Information

Birthdate:

Emerg. Contact:

Emerg. #:

Medical Information

List any medication presently taken:

Do you have any of the following conditions or requirements?:

Allergies:

Yes

Other Medical Conditions:

Yes

Please explain:

Please list any other ailments that the staff should be aware:

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