Parent Information

First Name *

Last Name *

Email *

Phone *

Address *

Postal code *

Player Information

Child's First Name *

Child's Last name *

Child's Date of Birth *

Youth Uniform Size *

Any Relevant Medical Information We Should Be Aware Of? *

ie. Asthma, Previous Injuries

Player Information (2)

Applicable ONLY for those that registered more than one child

IF ONLY ONE CHILD REGISTERED, skip to NEXT

Child 2's First Name

Child 2's Last Name

Child 2's Date of Birth

Child 2's Uniform Size

Any Relevant Medical Information We Should Be Aware Of - Child 2

ie. Asthma, Previous Injuries

Finalization

Emergency Contact Name

MUST BE DIFFERENT than parent listed above

Emergency Contact Phone Number