*OHIP Numbers are optional to collect and an optional field for this form*
Boys and Girls (please check appropriate box)
Born 2007U4Born 2003 – U8
Born 2006 U5 Born 2002 – U9
Born 2005 U6Born 2001 – U10
Born 2004 U7
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CONSENT FOR USE OF PERSONAL INFORMATION
I authorize the Canadian Soccer Association, the Ontario Soccer Association, Durham Regional Soccer Association, and Oshawa Kicks Soccer Club to collect and use personal information about me or my child/ward for the purpose of receiving communications from the Ontario Soccer Association, District, League and Club.
*We do not sell or distribute your personal information to any other third party not listed herein.*
ACCEPTANCE OF TERMS AND CONDITIONS
In consideration of the acceptance of my or my child/ward’s membership in the Ontario Soccer Association, District Association and Club, I, the participant and parent/guardian (if participant is under 18 years of age), agree as follows:
1. I am aware of The Ontario Soccer Association, Durham Regional Soccer Association, Oshawa Kicks Soccer Club and League bylaws, policies, rules and regulations and agree to abide by them and to be bound by them.
2. I accept sole responsibility for my or my child/ward’s personal possessions and athletic equipment.
3. I accept all liability for any damage to the playing equipment caused by me or my child/ward’s careless, negligent and/or improper handling.
4. I understand there will be no refunds given for indoor Futsal after October 1st 2010.
5. I consent to photographic and or vocal records of my child/ward while participating in soccer activities are the property of the person or association making such records to be used at the discretion of said owner.
I acknowledge that I have read this registration agreement in its entirety and that I have executed this registration agreement voluntarily.
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Print Name of Parent/GuardianSignature of Parent/GuardianDate
