Player Registration Form

Program Start Date

Program End Date

First Name *

Last Name *

Date of Birth *

Gender *MaleFemale

Email *

Phone

Home

Cell *

Address

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Parent/Guardian Name *

Medical Conditions0 / 300

Emergency

Name

Phone

Relationship

Acceptance of Terms and Conditions

I do hereby approve my child’s participation in the Future Stars Soccer.
I certify my child is in good health and able to participate with no limitations.
In the event that a medical emergency occurs and I am not on the premises or cannot be contact, I give my permission to secure medical attention
I do release Future Star Soccer of all liabilities due to an injury or illness to my child.
I have reviewed the waiver of liability and release form attached and my signature affixed hereto indicates my agreement with such waiver of liability and release form.

Payment

Discount for 2+ Children

If you are going to be registering 2+ children, you are eligible for our discount program. Before submitting the application, please contact the office to discuss how much payment is to be made for each child. In the meantime, you can press the save as draft option below to save the application and return to it once payment details are discussed.

Age

Program *

Fundamental Training

Program *

Session Duration	Number of Sessions	Program Length
6 hours/week	3 / week	60 hours

Total

Total + HST

Include Price

Include Price + HST

Final Price

Final Price + HST

Payment Options

I have already paid

Payment Steps

Contact office to discuss details (For contact options, see the Contact page)

Phone *Give this number to office when going to pay so we can put it on file

Payment Steps

Make cheque payable to Future Star Soccer
Contact office to discuss details (For contact options, see the Contact page)

Phone *Give this number to office when going to pay so we can put it on file

Phone *Enter the phone number we have for you on file

Payment Steps

Send transfer to the email: futurestarsoccer416@gmail.com
Make sure that the email (required) and phone number (optional) used match the ones inputted below
Await confirmation email

Email Address *Your E-Transfer Email

Phone (Optional)Your E-Trasnfer Number

Payment Steps

Register for one of the financial assistance programs listed in Pricing
When received confirmation number, please notify the office (For contact options, see the Contact page)

Date of Application

Additional Remarks That Are Necessary for Management

Save as Draft