Winter Soccer Program Registration (Monthly Payment Plan)

Winter Soccer Programs Registration (Monthly Payment)
Player Information
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School
Guardian 1 Information
Name*

First NameLast 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 NameLast 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 NameLast 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 NameLast Name
Home Phone
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email
example@example.com

How did you hear about us?*
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*

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Parent Code of Conduct
Please acknowledge your agreement of Parent Code of Conduct and sign*

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My Products*
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Development Blue I (Tuesdays)
$125.00 for the first month, 3 equal payments of $97afterwards

$125.00CAD for the first payment then,$97.00CAD for each month



Development Blue I (Wednesdays)
$125 for the first month, 3 equal payments of $97 afterwards

$125.00CAD for the first payment then,$97.00CAD for each month



Development Blue II (Tuesdays & Wednesdays) (2016 born or older players)
$220 for the first month, 3 equal payments of $172 afterwards

$220.00CAD for the first payment then,$172.00CAD for each month



Development Yellow I (Mondays Only) (2017-2019 born players)
$125 for the first month, 3 equal payments of $97 afterwards

$125.00CAD for the first payment then,$97.00CAD for each month



Future Stars I (Wednesdays)
$158.00 for the first month, 6 equal payments of $ 92.00 afterwards

$158.00CAD for the first payment then,$92.00CAD for each month



U9 Rep. Team
$564.00 for the first month, 6 equal payments of $219.00 afterwards

$564.00CAD for the first payment then,$219.00CAD 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

$953.00CAD for the first payment then,$247.00CAD for each month



U10-U13 Rep. Team
$790.00 for the first month, 6 equal payments of $307.00 afterwards

$790.00CAD for the first payment then,$307.00CAD 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

$1,156.00CAD for the first payment then,$300.00CAD for each month
Should be Empty:

Winter Soccer Programs Registration (Monthly Payment)

Player Information

Guardian 1 Information

Guardian 2 Information

Primary Emergency Contact

Secondary Emergency Contact

Ontario Soccer Player Waiver Form

Parent Code of Conduct