Summer Soccer Program Registration (Monthly Payment Plan)

Summer Soccer Program Registration (Monthly Payment Plan)
Program*
Player Information
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School
Guardian 1 Information
Name*

First NameLast Name
Relationship to student*
Home Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Guardian 2 Information
Name

First NameLast Name
Relationship to Student
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Primary Emergency Contact
Name*

First NameLast Name
Home Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Secondary Emergency Contact
Name*

First NameLast Name
Home Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email
example@example.com

How did you hear about us?*
If you are referred by someone from our club, what is his/her name?
Does the student have any allergies that we need to be aware of? If yes, please specify.*
Does the student have any other medical conditions that we need to be aware of? If yes, please specify.*
Ontario Soccer Player Waiver Form
It is mandatory for Ontario soccer players to sign after reading above Ontario Soccer Player Waiver Form

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Parent Code of Conduct
Please acknowledge your agreement of Parent Code of Conduct and sign

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Development I (Thursdays) (Early Bird Rate)
First payment: $72 6 equal payments after: $26 per month

$72.00CAD for the first payment then,$26.00CAD for each month



Development I (Sundays) (Early Bird Rate)
First payment: $72 6 equal payments after: $26 per month

$72.00CAD for the first payment then,$26.00CAD for each month



Development II (Mondays & Wednesdays) (Early Bird Rate)
First payment: $128 6 equal payments after: $47 per month

$128.00CAD for the first payment then,$47.00CAD for each month



Future Stars (Thursdays) (Early Bird Rate)
First payment: $72 6 equal payments after: $26 per month

$72.00CAD for the first payment then,$26.00CAD for each month



Future Stars (Sundays) (Early Bird Rate)
First payment: $72 6 equal payments after: $26 per month

$72.00CAD for the first payment then,$26.00CAD for each month



Future Stars II (Mondays & Wednesdays) (Early Bird Rate)
First payment: $128 6 equal payments after: $47 per month

$128.00CAD for the first payment then,$47.00CAD for each month



Super Girls (Thursdays Only) (Early Bird Rate)
First payment: $72 6 equal payments after: $26 per month

$72.00CAD for the first payment then,$26.00CAD for each month
Should be Empty:

Summer Soccer Program Registration (Monthly Payment Plan)

Player Information

Guardian 1 Information

Guardian 2 Information

Primary Emergency Contact

Secondary Emergency Contact

Ontario Soccer Player Waiver Form

Parent Code of Conduct