Winnipeg Mini Soccer League Registration and Enrollment for Children

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Registration:

Drop off completed registration forms and payment to the "The Red Card Soccer Store" located at 211 Chancellor Matheson Road (University of Manitoba). The form may be filled in below and printed out or downloaded and completed. Payment may be made Cash, or Cheques made payable to the "Wpg. Mini Soccer League"

2010-2011 *INDOOR MINI* REGISTRATION FORM

Child's Name:	Please enter Child's Name
Parents / Guardians of Child:	Please enter Parent's Name
Child’s Date of Birth:	Please enter Child's DOB
Gender:	Male Female Please select a gender
Address:	Please enter Address

City:	Please enter City
Postal Code:	Please enter Postal code
Phone Number:	Please enter Phone No.
Work/Cell:
Email: (for scheduling and league info updates)	Please enter Email Address
Shirt Size:	YS YM YL AS Please select Shirt's size
Request to play with friends: (list them here)
Interested in Coaching your child’s youth team:	Yes No
Individual Registration paid in full:	$275.00
Date:

Please read and sign the Waiver Below:
I hereby for myself, my heirs, executors, administrators and sponsors waive and release any all rights and claims that may arise against the Wpg. Indoor Mini Soccer League. I waive and release it’s affiliated associations, sponsors, agents, or representatives, for any and all injuries or losses suffered while competing in or in connection with the leagues and programs of the Wpg. Indoor Mini Soccer League.

Waiver Signature: ____________________________ Date: ___________________________