Mini Soccer

Earl Grey Community Centre Mini Soccer Registration
You will need to fill out one registration per child. At the end of the regsitration form you will be taken to our payment portal. Once you have completed the regsitration and payment you can start a new registration form for the next child.
CHILD INFORMATION:
Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Best practice day

Monday/WednesdayTuesday/Thursday
Current daycare or school
Buddy Request
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*
example@example.com
UNIFORM INFORMATION
Youth Shirt
Adult Shirt
MEDICAL INFORMATION
Manitoba Health PIN
Manitoba Health Registration # ( short )
Medical Concerns
REGISTRATION PAYMENT
Parents with multiple children enrolled will be charged full price ($75) for the first registered child and receive a $10 discount for each child thereafter.

Please select one option below. If it is your first or only child, please select the First Child option. If you are registering your second or more child(ren) please select the Additional Child option.

Your child must be 3 years old by December 31,2024 to register.

Subsidy requests can per made @egcc@mymts.net and a coupon code will be given to register.

My Products

Soccer Registration - First Child

$75.00CAD

Soccer Registration - Additional Child

$65.00CAD

Enter coupon

I UNDERSTAND THAT BY COMPLETING THIS FORM, THE CITY COMMUNITY CENTRE IS COLLECTING CERTAIN INFORMATION ABOUT MY CHILD, MYSELF AND OTHER FAMILY MEMBERS INCLUDING WHEN NECESSARY MY MANITOBA HEALTH REGISTRATION NUMBER.

I ALSO UNDERSTAND THAT THIS PERSONAL INFORMATION WILL BE USED FOR THE PURPOSE OF REGISTERING IN THE COMMUNITY
CENTRE SPORT RECREATION AND LEISURE PROGRAMS AND THAT SUCH USE SHALL INVOLVE THE DISCLOSURE OF THIS PERSONAL
INFORMATION TO THE APPROPRIATE SPORT ASSOCIATION(S), COACH (ES) AND MANAGERS
Should be Empty:

Earl Grey Community Centre Mini Soccer Registration