LITTLE MOVERS 2021

Earl Grey Community Centre will adhere to the current Manitoba Public Health Covid-19 orders . This is includes the Mandatory collection of Contact information , Social distancing, Mandatory Masks and sanitazation. The Community Centre will provide a labled ball to each Player that must come with them to field each Soccer Day.
LITTLE MOVERS 2021 Registration Form

Please fill in the form below.
Childs Full Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Caregivers Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
Manitoba Health *

short number Long number
BEST PRACTICE DAY *

MONDAYS AND WEDNESDAYS TUESDAYS AND THURSDAYS
BUDDY REQUEST
FRIEND THEY WOULD LIKE TO PLAY WITH
CURRENT SCHOOL
Childs Age by year *

2017/2018
Behaviour or health concerns
to help us make it the best experience.
I UNDERSTAND THAT BY COMPLETING THIS FORM, THE CITY COMMUNITY CENTRE IS COLLECTING CERTAIN INFORMATION ABOUT MY CHILD, MYSELF AND OTHER FAMILY MEMBERS INCLUDING WHEN NECESSARY MY MANITOBA HEALTH REGISTRATION NUMBER.

I ALSO UNDERSTAND THAT THIS PERSONAL INFORMATION WILL BE USED FOR THE PURPOSE OF REGISTERING IN THE COMMUNITY
CENTRE SPORT RECREATION AND LEISURE PROGRAMS AND THAT SUCH USE SHALL INVOLVE THE DISCLOSURE OF THIS PERSONAL
INFORMATION TO THE APPROPRIATE SPORT ASSOCIATION(S), COACH (ES) AND MANAGERS
Should be Empty:

LITTLE MOVERS 2021 Registration Form