Outdoor Soccer Registration Form

Soccer Details:

  • Timbits Outdoor Soccer (Runs May and June, Tuesday and Thursday evenings)  Ages 4-6 (40 minutes, twice per week, starts at 6 pm)
    • Registration: $50
    • IMPORTANT NOTE: The first 2 parent volunteers will get a $15 reduction on their child's registration (see checkbox below)

  • Outdoor Soccer (Runs May and June, Tuesday and Thursday evenings)  Ages 6-12 (1 hour, twice per week, starts at 6 pm)
    • Early bird registration: $75 (BY APRIL 12TH) 
    • Regular registration: $100 
    • IMPORTANT NOTE: The first 2 parent volunteers will get a $25 reduction on their child's registration (see checkbox below)
Sign in to Google to save your progress. Learn more
Participant Information
Participant's Full Name *
Date of Birth *
Gender *
Address *
Phone Number(s) *
Email Address (if the participant has one)
Parent/Guardian Information (if participant is under 18)

Write N/A for these questions if the participant is above 18 years of age.
Full Name *
I would like to be a parent volunteer for my child's soccer group (May - June).
Phone number(s) *
Email Address *
Emergency Contact (if different from parent/guardian) *
Program Registration
Program selection:  *
If you are interested in your child participating in a competitive soccer club (potential to join a league in Moose Jaw), please check this box.  The cost for this would be higher than the other soccer registration fees.  We will be in touch, if you check this box.
Medical/Safety Information
List any allergies or medical conditions
Emergency Consent:  I authorize the soccer coaches to obtain medical care if necessary." *
Required
Photo/video consent: “I consent to the participant's photo or video being used for club promotion.” *
Required
Acknowledgement
I acknowledgement that I have read the Rec board policies as found here. *
Required
I acknowledgment that in submitting this form, I agree to pay the registration and abide by policies laid out. *
Required
Signature (must be older than 18 years of age) 

By typing your name and the date below, you confirm that the above information is accurate.
 *
THANK YOU FOR YOUR REGISTRATION! 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms