BOURKEVALE COMMUNITY CLUB
SOCCER REGISTRATION FORM
(Please Print)
Today’s date: Spring 2018 Outdoor Season
PLAYER INFORMATION
Mini: U5-8
U5/6 (Tuesday/Thursday)
Player’s last name: First:
U7/8 (Monday/Wednesday)
Youth Recreational: U9-18
Birth date: (month &
Age: Sex: F M
year only)
Street address: Apartment/Unit: Home phone no.:
( )
City: Province: Postal Code:
Parent name: Email address: Contact number:
( )
Contact number:
Parent name: Email address:
( )
ADDITIONAL INFORMATION
Volunteer are required to assist with the following:
Coach Assistant coach Team liaison Referee Board member
5 to 8 year old $55 U9/U10 $180 U13/U18 $230
U11/U12 $200
bcchallrentals@outlook.com
Payment: Cash Cheque
Etransfer
Please refer to SCSA & WYSA for Privacy Policy, waivers for injuries and disclosure of player information.
wysa@shaw.ca www.winnipegyouthsoccer.com
Parent/Guardian signature Date