Course Registration Form

Registration Form

Fill out the form carefully for registration
Attendee Name

First NameLast Name
Club/Association
Birth Date

MonthDayYear
Gender
E-mail
example@example.com
I agree to Soccability Canada communicating with me on program updates. (Limited to 1 communication per month).
I understand that soccer is a contact sport and comes with inherent risk. I have reviewed the Participation Waiver below, and agree:
I agree to Soccability Canada using images and video of my participation.
Course Selection
Rate your experience and knowledge of disability sport in general (with 1 as a strong knowledge and 5 as no knowledge).
Additional Comments
We value your interest in soccer for people with a disability and hope that this experience will assist you in growing the game in your community. Let us know if there is anything we can do to assist you further in this journey.
Should be Empty: