Recreational Summer Soccer Program Registration (Lumpsum)
Program
*
Please Select
Development IB (once a week)
Development IIB (twice a week)
Future Stars IB (once a week)
Future Stars IIB (twice a week)
Super Girls B
Multi-sports Summer Camp
Player Information
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
M
F
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
Guardian 1 Information
Name
*
First Name
Last Name
Relationship to student
*
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Guardian 2 Information
Name
First Name
Last Name
Relationship to Student
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Primary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Secondary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Back
Next
How did you hear about us?
*
Please Select
Come-back players
Friends Referral
Social Media
Google Search
If you are referred by someone from our club, what is his/her name?
Does the student have any allergies that we need to be aware of? If yes, please specify.
*
Does the student have any other medical conditions that we need to be aware of? If yes, please specify.
*
My Products
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Development IB (Thursdays) (July & August)
$150.00 CAD
$
150.00
CAD
Development IB (Sundays) (July & August)
$150.00 CAD
$
150.00
CAD
Development IIB (Mondays & Wednesdays) (July & August)
$230.00 CAD
$
230.00
CAD
Future Stars IB (Thursdays) (July & August)
$150.00 CAD
$
150.00
CAD
Future Stars IB (Sundays) (July & August)
$150.00 CAD
$
150.00
CAD
Future Stars IIB (Mondays & Wednesdays) (July & August)
$230.00 CAD
$
230.00
CAD
Super Girls B (Thursdays) (July & August)
$150.00 CAD
$
150.00
CAD
Multi-sports Summer Camp (Weekly)
$198.00 CAD
$
198.00
CAD
Quantity
Price
July 6th Week
1
$198.00 CAD
$
198.00
CAD
July 13th Week
1
$198.00 CAD
$
198.00
CAD
July 20th Week
1
$198.00 CAD
$
198.00
CAD
July 27th Week
1
$198.00 CAD
$
198.00
CAD
August 4th Week
1
$158.00 CAD
$
158.00
CAD
August 10th Week
1
$198.00 CAD
$
198.00
CAD
Payment Methods
Debit or Credit Card
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make your payment.
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