Contact Information |
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| Player Gender |
Male
Female |
| Player Date of Birth: |
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| Player's Last Name: |
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| Player's First Name: |
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| Address: |
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| City: |
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| Post Code (eg S3N 1K9): |
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| Phone Number (Home): |
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| Phone Number (Work): |
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| Cell Phone: |
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| Email Address: |
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Player Information |
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| Emergency Contact Name: |
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| Emergency Contact Phone Number: |
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| Alternate Contact Name: |
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| Alternate Contact Phone Number: |
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| Family Doctor Name: |
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| Family Doctor Phone Number: |
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| Medications: |
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| Allergies: |
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| Previous Injuries: |
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| Does player carry and know how to administer his/her medicine? |
Check if Yes |
| Other (Braces, Contact Lenses etc): |
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Liability Waiver / Release |
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The goal of Yorkton United F.C. is to provide the opportunity for as many quallifying players as possible to enjoy the experience of playing soccer. Keeping with this goal, the Yorkton United F.C. has set forth the above policies and by checking the box on this form, you agree to these policies. In addition, the Player/Parent/Guardian acknowleges that playing soccer is an activity, which includes risks, which can result in physical injury under normal playing conditions. You consent to yourself, or your child participating in the soccer programs of the Yorkton United F.C. You release the Yorkton United F.C., its Directors, Offices, Agents or Representatives with respect to any claims, damages or liability arising from physical injury sustained by yourself or your child while particiapating in Club sponsered or supervised activies. |
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You must agree to be able register. Check box if you agree to these terms. |
Previous Expereince (Optional) |
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| Years Played: |
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| Recreational Seasons Played (Indoor): |
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| Recreational Seasons Played (Outdoor): |
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| Competitive Seasons Played (Indoor): |
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| Competitive Seasons Played (Outdoor): |
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| Click the submit button to send your registration. |
You will be taken to a "thank you" page if the form is correctly submitted and accepted by our system. If you click submit and don't see the the thank you message, then please check your information and make sure you have filled in all form fields correctly. |
