Request to Modify Registration
Players Name
*
First Name
Last Name
Players Birthdate
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number (Cell)
*
Please enter a valid phone number.
Phone Number (Home)
*
Please enter a valid phone number.
Season (Year)
*
ex. 2020
Indoor or Outdoor
*
Indoor
Outdoor
Program Name
*
Boys or Girls Program
*
Boys
Girls
Other
Date last participated in soccer activity with team
*
-
Month
-
Day
Year
Date
Modification Requesting
*
Reason for modification to registration
*
Have the team staff members been made aware of the request for modification?
*
Have the team staff members been made aware of the request for modification?
*
Yes
No
Is the player financial account with the team in good standing?
*
Yes
No
Ontario Soccer De-registration Form (Competitive Only)
Browse Files
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Choose a file
Cancel
of
Medical Note
Browse Files
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Choose a file
Cancel
of
Parent/Guardian Signature
*
Clear
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Date of Request
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: