North York Hearts Soccer Club

TEMPORARILY DISCONTINUED EMPORARILY DISCONTINUED

House League Indoor Registration

Online Registration Form(All Payments in Cad $)

HOUSE LEAGUE INDOOR 2007 - 2008

Online Credit Card Payment is COMING SOON. In the meantime, if you want to pay by Credit Card, register your child(ren), call the office with your Credit Card Informaton and we will complete the process.

A REQUEST TO COACH FORM MUST BE COMPLETED FOR EACH TEAM BEING REQUESTED TO COACH. COMPLETED FORMS MUST BE SUBMITTED(EMAILED) TO THE CLUB (Click Here)

Cost per player:

$150.00 per session

In the Special Request Section of the Form, please indicate the specific session numbers in which you wish to play

CLICK HERE FOR INDOOR REGISTRATION INSTRUCTIONS

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:
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:
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:
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:
CONTACT INFORMATION
APT #:
ADDRESS:
CITY/TOWN:
POSTAL CODE:
TELEPHONE (HOME):
TELEPHONE (BUSINESS):
EMAIL ADDRESS:
PARENT/GUARDIAN INFORMATION
FIRST NAME:
LAST NAME:
COMMENTS:
COACHING REQUEST
WOULD YOU LIKE TO COACH:	Yes No
SPONSOR REQUEST
WOULD YOU LIKE TO SPONSOR A TEAM:	Yes No