MINI SOCCER 2023

MINI SOCCER 2023 Registration Form

Please fill in the form below.
Childs Full Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Caregivers Full Name*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Manitoba Health*

short numberLong number
BEST PRACTICE DAY*

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

2020/20192018/20172016/2015/2014
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
My Products
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Mini Soccer 2020$75.00CAD
Mini Soccer and wind up

Total $0.00CAD
Should be Empty:

MINI SOCCER 2023 Registration Form