GN Sporting Club

Society No. S55828

Registration Form
									       
Player’s First Name: _______________________________ ;	Last Name: _______________________________________

Birth date: ________________________ (DD/MM/YYYY) ;	Gender: _____ Male	_____ Female

Address: _______________________ _________________ ;  City: ___________________ ;  Postal Code: ______-______

Home Phone #: ___________________________________ ;  Cell Phone #: ______________________________________

Email Address: ___________________________________ ;  Care Card No.: _____________________________________

Dad’s Name: _____________________________________ ;  Mom’s Name: _____________________________________

Emergency Contact: _______________________________ ;  Phone: ___________________ ;  Relationship: ___________

** All participants must comply with Code of Conduct as shown on Guru Nanak Sporting Club, and relevant 
organizations  (eg. BC Soccer) Web Sites **

			 

I, (Please Print) ___________________________________, the Parent / Guardian of the player listed above, acknowledge the fact that my son/daughter’s participation in soccer may entail unknown and unanticipated risks, which could result in various physical and emotional injuries. Therefore, I agree that Guru Nanak Sporting Club will not be held responsible for any accidents or injuries to my child that may arise from participating in practices, games and/or tournaments. I hereby release and agree to save harmless and indemnify the Club, the individual members of the Executive Committee of the Club, coaches, managers, referees, participating parents and any others involved with Guru Nanak Sporting Club from any and all claims, demands and suits that may arise in any matter from any personal injury or damage to the property of the above named player participating in Guru Nanak Sporting Club activities, whether or not such claims arise from the actions or conduct of the executive, coaches, referees, managers, assisting or participating parents and others involved in activities.

Division (Please Circle One)	_____ Boys	_____ Girls

U-6		U-7		U-8		U-9		U-10		U-11		U-12

U-13	U-14	U-15	U-16	U-17		U-18		OPEN

		

Registration Fee: $200.00 before April 30 - $225.00 after April 30
Make cheque payable to GN Sporting Club (cash will not be accepted)

Parent Signature: _____________________________________	Date: _______________________

Society No.: S55828 						        GN Sporting Club
		
		

OFFICIAL TAX RECEIPT

		
Parent’s Name: ______________________________________________________________________________________

Address: ____________________________________________________________________________________________

Amount: $ _____________________  Cheque # ____________________  Date: __________________________________

Authorized Signature: _________________________________________