Summer Session Registration

Player's First Name *

Player's Last Name *

Emergency Contact Name *

Emergency Contact Phone Number*

What are you registering for?

Your E-mail *

Phone Number

Child's Birth Date *

Month:
Day:
Year:

Current Club

Age Group
Current Playing Level

Your Address *


City

Province

Postal Code

Country

Fees:
Subsidized fee $100 per player, per program (Spring or Summer program), $150 discounted rate when you register for both Spring and Summer programs.
Online Registration REQUIRED for all kids in each Category.

Registration Payment Option

All checks payable to African Canadian Soccer or ACSCA with memo your child's LAST NAME. Please email Interac e-Transfer to info@acsca.net with password PLAYER's LASTNAME

Canadian Tire Jumpstart Program sponsors part of our Youth Soccer Program. Can we share your information with them so they can talk to you directly regarding the program?
YesNo

I, the parent/guardian of the above named player, a minor, agree that I and the player will abide by the rules and regulations of Africa United FC, its affiliated organizations and sponsors. In consideration of the player's participation in the soccer programs intending to be legally bound, I hereby release and indemnify Africa United FC, and its owners and operators of the facilities used for the programs and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the program including, without limitation, player's transportation to/from any program, which transportation is hereby authorized.

I also consent that I have read and understood the Code of Conduct.

Do you agree with the terms? *
Yes

Shirt/Jersey Size

Comments

* are mandatory fields