LEASIDE-EAST TORONTO SOCCER CLUB
193 RANDOLPH RD, Toronto, ON M4G 3S6 Telephone 416 481 6425
2021 OUTDOOR REGISTRATION
Mail the form together with a cheque
for $215.00 for youth, $240.00 for adult,
payable to the Leaside Soccer Association
to 193 RANDOLPH RD, Toronto, ON M4G 3S6
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( ).
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 me or my child while playing soccer
or engaging in any other Leaside-East Toronto Soccer Club activities.
PARENT SIGNATURE _____________ ________________________ DATE ______________________