Registration Form

Name of Player:
Mailing Address:
City/Province:

Postal Code:

Home Phone:
Emergency Phone:
Date of Birth
Position:
Gender:
Male Female
Shirt Size:
ExSmall Small Med Large
Parent/Guardian Name:
E-mail:
Winter Indoor League U3-U5(2005-2003)(full)
Winter Indoor League U6-U8(2002-2000)
Winter Indoor League U8-U10(2000-1998)
Burlington Friday Night U4/5/6(2003-04-05)
Burlington Saturday Morning U4/5/6(2005-04-03)
Burlington U7/8 Saturday Morning(2002/2001)
Burlington U9+ Saturday Morning(2000-1996)
Burlington U3 Saturday Program(2006)
Waterdown U4/5/6  Monday Night(2005-04-03)
Waterdown U7/8 Tuesday Night(2002/2001)
Summer Camp Registration
I am interested in sponsorship of a team:
Yes

Parent/Guardian Acknowledgement, I the parent of the applicant, release you and any officials acting on your behalf from any actions or lawsuits arising from any injury or accident to the applicant during games, practices or any other activities while participating in your program. Also, by submitting this form, I certify that the information given in the application is true and accurate.

PLEASE MAIL CHEQUE PAYABLE TO SCOOBY SOCCER TO 621 DEERHURST DRIVE, BURLINGTON, ONTARIO L7L 5W6.