LEASIDE-EAST TORONTO SOCCER CLUB
2010 OUTDOOR REGISTRATION

Mail the form together with a cheque
for $140.00 for youth, $175.00 for adult,
payable to the Leaside Soccer Association
to  161 Roehampton Avenue, Toronto, ON M4P 1P9

REMEMBER: ADULTS ARE ESSENTIAL TO THE  RUNNING OF THE LEAGUE.
Anyone interested in helping should mark their interest in the appropriate box.:
I would like to coach  (    ); help a coach(  ).

______________________________________________________________________________________________
REGISTRATION FORM

Players name                    Division    Date of Birth

_____________________________   _______     Month  _______  Day  _______    Year  _______


______________________  ___________      _______________  _______________  ________________
Address                 Postal Code      Home Tel. #      Work Tel. #      e mail

I certify the above information to be correct. I recognize that there is a potential risk
in participating in any sport.   I absolve the coaches and officials of the Leaside-East
Toronto Soccer Club of any liability in respect to injury to my child while playing soccer
or engaging in any other Leaside-East Toronto Soccer Club activities.


PARENT SIGNATURE  _____________ ________________________    DATE  ______________________