Jump Start

1
Email Address of Parent/Guardian* This field is required.Please use your most commonly checked email address.
example@example.com
2
Choose the appropriate team for your child.* This field is required.
U3 (2023 or later) $25
U5 (2021-22) $75
U7 (2019-20) $85
U9 (2017-18) $100
U11 (2016-15) $125
U13 Travel (2013-14) $230
U15 Travel (2011-12) $230
U17 Travel (2010-09) $230
3
Child's Name* This field is required.
First Name
Last Name
4
Child's Gender* This field is required.
Male
Female
5
Child's Birthday* This field is required.
Date
Year
Month
Day
6
Address of Child* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Any medical conditions and/or allergies relevant to playing soccer?Please describe. This information will only be shared with coaches involved directly with the child.
Huge
Large
Normal
Small
Ok
Ok
8
Parent #1 Name* This field is required.
First Name
Last Name
9
Parent #1 Phone Number* This field is required.This will be provided to coaches for use in emergencies.
Please enter a valid phone number.
10
Parent #2 Name
First Name
Last Name
11
Parent #2 Phone Number
Please enter a valid phone number.
12
Emergency Contact Name* This field is required.Please select someone who will be available when you might not be.
First Name
Last Name
13
Emergency Contact Phone Number* This field is required.
Please enter a valid phone number.
14
I give consent to images of the above-named child, to be taken while participating in the sport of soccer with the Hinton Soccer Society and to be used in the promotion, celebration, and sharing of the Hinton Soccer Society. The images can be published online, in local newspapers and in promotional items, such as flyers.

This consent is for the 2026 Hinton Soccer Society season.
15
I give consent for my child's image to be used for the purposes of the Hinton Soccer Society 2026.* This field is required.
YESNO
16
I have read and agree to abide by the Hinton Soccer Society's rules and bylaws.* This field is required.
YESNO
17
I agree to be respectful to everyone (coaches, players, refs, opposing teams, their parents, and their coaches).* This field is required.
YESNO
18
I am aware that this player requires black socks, black shorts, and shin guards and cleats to play soccer with the Hinton Soccer Society.* This field is required.
YESNO
19
I am aware, if I am registering my child for a travel team, I am required to transport my child or arrange transportation with others.* This field is required.
YESNO
20
I have applied for:* This field is required.https://jumpstart.canadiantire.ca/pages/individual-child-grants
Jump Start (copy the link above if you have not yet applied)
I can make payments
21
Are you interested in helping with the 2026 season of the Hinton Soccer Society?* This field is required.We need your help to make this year amazing!
Referee
Coaching
Field Maintenance
Other
No thanks
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