Winter Soccer Program Registrations (Lumpsum Payment)
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
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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 if the club needs special accommodation for the session.
*
Ontario Soccer Player Waiver Form
It is mandatory for Ontario soccer players to sign after reading above Ontario Soccer Player Waiver Form
*
Parent Code of Conduct
Please acknowledge your agreement of Parent Code of Conduct and sign
*
My Products
*
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Development Blue I (Tuesdays Only) (2016 born or older)
$277.00 CAD
$
277.00
CAD
Development Blue I (Wednesdays) (2016 born or older)
$277.00 CAD
$
277.00
CAD
Development Blue II (Tuesdays & Wednesdays) (2016 born or older)
$488.00 CAD
$
488.00
CAD
Development Yellow (Mondays Only) (2019-2017 born)
$277.00 CAD
$
277.00
CAD
Future Stars I (Wednesday)
$277.00 CAD
$
277.00
CAD
U9 Rep. Team
$1,585.00 CAD
$
1,585.00
CAD
U9 Rep. Team (Full membership, 2025 winter & 2026 summer)
$2,678.00 CAD
$
2,678.00
CAD
U10-U13 Rep. Team
$2,219.00 CAD
$
2,219.00
CAD
U10-U13 Rep. Teams (Full membership, 2025 Winter & 2026 Summer)
$3,248.00 CAD
$
3,248.00
CAD
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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