North York Hearts Soccer Club

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Online Registration Form (All Payments in Cdn $)

		Credit Card-Visa or Master Card payments can be done online. ALL ONLINE REGISTRANTS MUST PRINT THE PARENT'S LETTER (Please Click Here) Registration Fees: Micros (Born 2006); Minis (Born 2005, 2004) ---- $140 Tykes (Born 2003); Squirts (Born 2002); Minor Atoms (Born 2001, 2000); Atoms (Born 1999, 1998); Mosquitoes (Born 1997, 1996); Pee Wees (Born 1995, 1994); Bantams (Born 1993-1987)-----$160 IMPORTANT MESSAGES IF YOU ARE REQUESTING TO PLAY WITH SOMEONE PLEASE READ INSTRUCTIONS BEFORE COMPLETING THE REGISTRATION (CLICK HERE) BEFORE REGISTERING, CLICK HERE TO READ PARTICIPATION AGREEMENT AND "HOW WE OPERATE".
		CLICK HERE FOR INSTRUCTIONS ON HOW TO COMPLETE OUTDOOR ONLINE REGISTRATION FORM

REGISTRATION FOR THE OUTDOOR 2011 SEASON BEGINS ON NOVEMBER 1ST 2006

Number of Players to be registered:

PLAYER #1 - INFORMATION
FIRST NAME:
LAST NAME:
GENDER:	Male Female
DATE OF BIRTH:	- - (mm-dd-yyyy)
SCHOOL ATTENDING:
WOULD YOU LIKE TO PLAY GOAL:	Yes No
MEDICAL CONDITIONS (PLEASE SPECIFY)
*SPECIAL REQUEST:
PARENT/GUARDIAN - WOULD YOU LIKE TO COACH:	Yes No
PLAYER #2 - INFORMATION
FIRST NAME:
LAST NAME:
GENDER:	Male Female
DATE OF BIRTH:	- - (mm-dd-yyyy)
SCHOOL ATTENDING:
WOULD YOU LIKE TO PLAY GOAL:	Yes No
MEDICAL CONDITIONS (PLEASE SPECIFY)
*SPECIAL REQUEST:
PARENT/GUARDIAN - WOULD YOU LIKE TO COACH:	Yes No
PLAYER #3 - INFORMATION
FIRST NAME:
LAST NAME:
GENDER:	Male Female
DATE OF BIRTH:	- - (mm-dd-yyyy)
SCHOOL ATTENDING:
WOULD YOU LIKE TO PLAY GOAL:	Yes No
MEDICAL CONDITIONS (PLEASE SPECIFY)
*SPECIAL REQUEST:
PARENT/GUARDIAN - WOULD YOU LIKE TO COACH:	Yes No
PLAYER #4 - INFORMATION
FIRST NAME:
LAST NAME:
GENDER:	Male Female
DATE OF BIRTH:	- - (mm-dd-yyyy)
SCHOOL ATTENDING:
WOULD YOU LIKE TO PLAY GOAL:	Yes No
MEDICAL CONDITIONS (PLEASE SPECIFY)
*SPECIAL REQUEST:
PARENT/GUARDIAN - WOULD YOU LIKE TO COACH:	Yes No
CONTACT INFORMATION
APT #:
ADDRESS:
CITY/TOWN:
POSTAL CODE:
TELEPHONE (HOME):
TELEPHONE (BUSINESS):
EMAIL ADDRESS:
PARENT/GUARDIAN INFORMATION
FIRST NAME:
LAST NAME:
COMMENTS:
SPONSOR REQUEST
WOULD YOU LIKE TO SPONSOR A TEAM:	Yes No