Winter Soccer Programs Registration (Monthly 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.
Cell Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Guardian 2 Information
Name
First Name
Last Name
Relationship to Student
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Primary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Secondary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
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.
*
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 Yellow I (Mondays Only) (2017-2019 born players)
$183.00 for the first month, 6 equal payments of $71.00 afterwards
$
183.00
CAD
for the
first payment
then,
$
71.00
CAD
for each
month
Development Yellow II (Mondays & Tuesdays) (2017-2019 born players)
$324 for the first month, 6 equal payments of $126 afterwards
$
324.00
CAD
for the
first payment
then,
$
126.00
CAD
for each
month
Development Yellow II (Mondays & Wednesdays) (2017-2019 born players)
$324 for the first payment, 6 equal payments of $126 afterwards
$
324.00
CAD
for the
first payment
then,
$
126.00
CAD
for each
month
Development Blue II (Tuesdays & Wednesdays) (2016 born or older players)
$324 for the first month, 6 equal payments of $126 afterwards
$
324.00
CAD
for the
first payment
then,
$
126.00
CAD
for each
month
Future Stars I (Wednesdays)
$183.00 for the first month, 6 equal payments of $ 71.00 afterwards
$
183.00
CAD
for the
first payment
then,
$
71.00
CAD
for each
month
U9 Rep. Team
$564.00 for the first month, 6 equal payments of $219.00 afterwards
$
564.00
CAD
for the
first payment
then,
$
219.00
CAD
for each
month
U9 Rep. Team (Full membership, 2025 winter & 2026 summer)
$953.00 for the first month, 9 equal payments of $247.00 afterwards
$
953.00
CAD
for the
first payment
then,
$
247.00
CAD
for each
month
U10-U13 Rep. Team
$790.00 for the first month, 6 equal payments of $307.00 afterwards
$
790.00
CAD
for the
first payment
then,
$
307.00
CAD
for each
month
U10-U13 Rep. Team (Full membership, 2025 winter & 2026 summer)
$1,156.00 for the first month, 9 equal payments of $300.00 afterwards
$
1,156.00
CAD
for the
first payment
then,
$
300.00
CAD
for each
month
Continue
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