Mail-in Registration Form

Mail this form together with a cheque for $230.00 for youth,

payable to: Leaside Soccer Association 193 Randolph Road, Toronto, ON M4G 3S6 Remember: Adults are essential to the running of the league. Anyone interested in helping should mark their interest below: I would like to coach ( ) or, help a coach ( ) Registration Form ________________________ _________________ ________________________ Player's Name Division Date of Birth (mm/dd/yy) ________________________ ___________ _______________ ________________ Address Postal Code Telephone Email 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 me or my child while playing soccer or engaging in any other Leaside-East Toronto Soccer Club activities. __________________________________ ______________________ Parent Signature Date