Bradford Soccer Club –Outdoor Registration Form

1. Bradford Soccer Club –Outdoor Registration Form 31 Frederick Street, P.O. Box 214, Bradford, Ontario, L3Z 2A8 (905) 775-7000 www.bradfordsoccer.com This is a registration form only. Official Tax Receipt will be processed and E-mailed or Posted after completion of All Registration Periods. Payment receipts at time of Registration will be available for cash payments only. Player Information Full Name:______________________________________________________________ Last First M.I. Address: ______________________________________________________________ City: _____________________________ Postal Code:________________________ Phone:________________________ E-Mail:__________________________________ Date of Birth: ________________________ Male: ___ Female: ____ Parent Name: ______________________ Work:_____________ Cell:______________ Has the player ever registered to play soccer in another country? Yes No (please circle) if yes then a) Which country did you last register? ________________________ Club____________________ Year:__________ Consent for use of personal information I authorize the Canadian Soccer Association, Ontario Soccer Association, Huronia District Soccer Association About me and/or my child/ward for the purpose of receiving communications from the CSA,OSA,HDSA and BSC. I understand that I may withdraw such content related to receiving communications at any time by contacting the OSA Privacy Officer at: OSAPrivacyOfficer@soccr.on.ca or by mail to: Attention: OSA Privacy Ontario Soccer Association, 7601 Martin Grove Road, Vaughan, On L4L 9E4. The Privacy officer will advise the implication of such withdraw. We do not sell or distribute your personal information to any third party not listed herein. Acceptance of Terms and conditions In consideration of the acceptance of mine and/or my child/ward membership in the OSA,HDSA, and BSC, I the participant and/or the parent/guardian (for the participant under 18yrs of age) agree as Follows: 1. I understand that I and/or my child/ward cannot play in any sanctioned soccer game until after this registration form has been validated and the registration data has been entered in the OSA computerized registration system. 2) I have reviewed the participation agreement attached and my signature affixed hereto indicated my agreement with such participation agreement. 3) I am aware of the OSA,HDSA, and the BSC and league bylaws policies rules and regulations and agree to abide by them and be bound by them. 4) I accept sole responsibility for my and/or child/ward’s personal possessions and athletic equipment. 5) I accept all liability for any damage to the playing equipment caused by my and/or my child/ward’s negligent and/or improper handling. By Signing and dating below you agree that you are the player and/or parent or legal guardian of the player being registered and to be bound by the Legal Agreement even if you have not read the agreement. Signature______________________________________________________ Date:_____________________________ For Office Use Only: Cash: ________ Cheque:____________ Date: _______________________ Paid:____________________________ Entered:___________________________