2025 Summer HL Registration Form

ASANTE SOCCER ACADEMY

415 Oakdale Road, North York, ON

M3N 1W7

r.asante@asanteacademy.com

www.asanteacademy.com

(647) 881 9179
HOUSE LEAGUE REGISTRATION FORM

OUTDOOR
PROGRAM DETAILS

The program runs from May 21st to August 20th, 2025.

Practice: Monday at Beverley Heights Middle School (26 Troutebrooke Dr) from 6:30 pm to 7:30 pm.

Games: Wednesday at Beverley Heights Middle School (26 Troutebrooke Dr) from 6:30 pm to 7:30 pm.

Includes TWO game jerseys, ONE shorts, and 1 PAIR of socks.
Player information:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Age*
PARENT information:
Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
aDDITIONAL information:
Which Age Group Would You Like to Register For?*

Under 7-8Under 9-10Under 11-12Under 13-14
eMergency contact:
Full Name*

First NameLast Name
Phone Number*
Relationship to Player
MEDICAL INFORMATION
Does the player have any allergies, chronic illness, or medical conditions?*

YesNo
Please describe*
Player Health Card Number*
Waiver for participation:
I hereby register my child and I do understand that there is a potential for injury while participating in the programs offered by this club and I agree to hold harmless Asante Soccer Academy (ASA), the team, the officials, the league, or District Associations from any and all injuries sustained while playing for ASA at practice, games, or events.*

I agree
I agree to supply my child with soccer shoes and shin pads to be worn at all times during play and practices.*

I agree
I agree to abide by the rules and regulations of Asante Soccer Academy, the Ontario Soccer Association, and the North York Soccer Association.*

I agree
I consent to my child being publicized, filmed, audio taped, photographed, interviewed by employees, agents, or servants of ASA.*

I agree
PAYMENT

My Products*

Summer House League Registration

$200.00CAD

Enter coupon

Total

$0.00CAD

Payment Methods

Credit Card

Apple Pay

Google Pay

Should be Empty:

HOUSE LEAGUE REGISTRATION FORM

PROGRAM DETAILS

Player information:

PARENT information:

aDDITIONAL information:

eMergency contact:

MEDICAL INFORMATION

Waiver for participation:

PAYMENT

Payment Methods