ClubReg

ABC Soccer Club

Outdoor - Summer 2007

YOUTH HOUSE LEAGUE

Player Registration

Registration Cost, Fees & Refunds

Birth Year	# Nights	Registration Cost
1987 - 1999	2	$175
2000 (only)	1	$105

No refund for any reason after May 1

(except for wait-listed players).

NSF Cheques/Chargebacks

$25

Cancellation

$35

NOTE: There is a $5.00 handling charge included in the above costs.

Refunds can only be processed if the cancellation is received in writing at the Club office prior to May 1.

This registration can only be processed if:

This form is completed in full;

Payment is successfully made through PayPal; and,

Proof of age is provided for any players new to this club (copy of birth certificate can be emailed, faxed or dropped at the club).

This is a private club. This application may be accepted or not accepted at the discretion of the Board of Directors.

PLAYER INFORMATION

Hint: You can use the tab key to move from field-to-field (you don't need to use the mouse for most things).

	First Name	Last Name	Male Female


	Street	Apt


	Town / City	Postal Cd	dd mm yy birth day


	Home Phone	Business Phone	Cell Phone

		Yes No
	Email Address - Parent/Guardian/ Player 18+	Has this player registered with this club in a previous season?

Vacation

Expected vacation period when games & practices will be missed.

From:

To:

Last Soccer Registration

Ever Registered Outside Canada?

Year

Club

Year

Country

Club

Division X Players Only - Preferred Playing Night
none Monday Wednesday

VOLUNTEER & SPONSOR INFORMATION

As a volunteer organization, we need your help.


	Volunteer Name(s) / Sponsor Contact & Company Name	dd mm yy	Coach level
		birth date (coaches & asst coaches)

	Position
	Coach Asst Coach Convenor Other Vol Position Sponsor

PRIVACY

I understand as a registrant of the OSA, my District Association, my Club and my League (if applicable) that I may receive information from time to time related to soccer events, programs and services.Check this box if you prefer to be excluded from receiving this information.
Check here to be excluded

AGREEMENT & Disclaimer

You must be 18 years or older in order to (electronically) sign this agreement. A parent or guardian must sign for a minor. If this form is being filled out on behalf of a minor, please complete the three boxes below.

Name of person submitting and signing this form (first & last)
Relationship to the applicant (must be: Mother, Father or Legal Guardian)

I agree to participate (or to allow this child to participate, if signing on behalf of a minor) in the activities of the ABC Soccer Club. I understand and accept that there is a potential risk in training and participating in any sport; and, that the club tries to create a safe environment. I agree not to hold the ABC Soccer Club, its Directors or other club volunteers liable for any damages; loss; or injury sustained by this child and/or by me as a consequence of his/her/my participation in; or presence at: any programs, games or other activities of the ABC Soccer Club and I hereby release them from such claims.

I agree on my behalf (and on behalf of this child if signing for a minor) and on behalf of any other family members who may attend practices, games or club events to abide by the rules, policies and decisions of the ABC Soccer Club and its governing bodies (, OSA, CSA, FIFA). The Club has established rules for participation. Proper conduct on and about the field must be followed. I understand that a player may be removed from a league/team if more than three games are missed without an acceptable reason; or, if the continued participation by this player will result in safety concerns or otherwise adversely affect the enjoyment of the game by other players on the team / in that league.

I specifically grant permission to the ABC Soccer Club to use my/my child�s likeness, voice and words in television, radio, film, newsletters, magazines, and other media; and, in any form not heretofore described, for the purpose of advertising or communicating activities of the ABC Soccer Club.

Participant Agreement - Please review the Participant Agreement below.
Your electronic signature below includes your agreement to the content of this Participant Agreement on behalf of your child.

Participant's Agreement (To Be Used for Players Under the Age of 18)

ALL PROGRAMS AND ACTIVITIES HAVE THEIR RISKS
I participate in the game of soccer because it is physically and mentally challenging.  In consideration of my participation in such programs, activities and events, I hereby acknowledge that I am aware of the risks and hazards associated with or related to this activity. The risks and hazards include, but are not limited to:

* Injuries from executing strenuous and demanding physical techniques in soccer;
* Injuries from dryland training including weights, running, and massage;  
* Injuries from grass, turf and other surfaces including bacterial infections and rashes;
* Injuries resulting from falls to the ground due to uneven or irregular terrain or surfaces;
* Injuries from collisions with walls and soccer equipment;
* Iinjuries resulting from failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;
* Spinal cord injuries which may render me permanently paralyzed;
* Injuries from extreme weather conditions which may result in heatstroke, sunstroke or hypothermia;
* Injuries from contact, colliding or being struck by other participants, spectators, equipment or vehicles;
* Injuries resulting from vigorous physical exertion and strenuous cardiovascular workouts;
* Injuries from exerting and stretching various muscle groups; and
* Travel to and from competitive events and associated non-competitive events which are an integral part of the organization's activities.

Furthermore, I am aware:

* That injuries sustained in soccer can be severe;
* That I may experience anxiety while challenging myself during the activities;
* That I may come into close contact with other participants, including the possibility of accidental and unexpected contact;
* That my risk of injury is reduced if I follow all rules established for participation; and 
* That my risk of injury increases as I become fatigued.

I AGREE TO BE RESPONSIBLE FOR MYSELF

I am participating voluntarily in these activities, events and programs.  I agree that there are risks in soccer as described above.  By participating voluntarily in these events, activities and programs, I am exposed to these risks and hazards.  I agree to accept them and be responsible for any injury or other loss which I might receive while participating in these events, activities and programs.

If something happens to me, I release the organizers of responsibility for any claims, demands, actions and costs which might arise out of my participation.  In this Agreement I understand "organizers" to mean: The Ontario Soccer Association, District Associations, Leagues, Clubs and their directors, officers, members, employees, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of facilities, and representatives.

By electronically signing the online registration form in which this agreement is included, I agree that I have read and understood the terms and conditions of this Participant Agreement on my own behalf and on behalf of my child to whom this registration form applies. I  voluntarily agree to abide by these terms.  
 
(Based on OSA recommended Participant Agreement dated: Jan 27-06)

I hereby certify that all of the information that I have provided on this form is accurate and complete. I have read and understood; and, I accept all of the terms and conditions that are stipulated in this registration document. I understand that clicking on the button on the left constitutes an electronic signature and legally binds me in the same manner as signing a registration form.