Asante Soccer Academy Summer House League 2023
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DOB
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-
Month
-
Day
Year
Date
Age
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Parent / Guardian's Information
Name
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First Name
Last Name
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Which age group are you registering for?
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7-8
9-10
11-12
13-14
Waiver for Participation
I herby register my child and I do understand that there is a potential for injury while participating in the programs offered by your club and I agree to hold harmless Asante Soccer Academy (ASA), The Team, Officials, League, or District Associations from any and all injuries sustained while playing for ASA at practice, games, or events.*
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I Agree
I agree to supply my child with soccer shoes and shin pads to be worn at all times during play and practices.*
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I Agree
I agree to abide by the rules and regulations of Asante Soccer Academy, the Ontario Soccer Association and the North York Soccer Association.*
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I Agree
I consent to my child being publicized, filmed, audio taped, photographed, interviewed by employees. agents or servants of ASA.*
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I Agree
PAYMENT
Payment can be made by etransfer to asanterichard@hotmail.com or in cash!
Submit
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