West Grey Soccer Club
YOUTH PLAYER REGISTRATION FORM
UMBER, NAME & PO Box
Club Registration #: CD 0443
Club Name: West Grey Soccer Club
I authorize the Canadian Soccer Association, the Ontario Soccer Association, SWRSA and my Club to collect and use personal
information about me or my child/ward for the purpose of receiving communications from the Ontario Soccer Association,
SWRSA, League and Club.
I understand that I may withdraw such consent related to receiving communications at any time by contacting the OSA Privacy
Officer at OSAPrivacyOfficer@soccer.on.ca or by mail to: Attention: OSA Privacy Officer, Ontario Soccer Association,
7601 Martin Grove Road, Vaughan ON L4L 9E4. The Privacy Officer will advise the implications of such withdrawal.
*We do not sell or distribute your personal information to any other third party not listed herein.
In consideration of the acceptance of my or my child/ward’s membership in the Ontario Soccer Association, District Association and Club, I, the
participant and parent/guardian (if participant is under 18 years of age), agree as follows:
I understand that I 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 Ontario Soccer Association's computerized registration system.
I have reviewed the waiver/participation agreement attached and my signature affixed hereto indicates my agreement with such
I am aware of The Ontario Soccer Association, SWRSA, West Grey Soccer Club and League bylaws, policies, rules and regulations
and agree to abide by them and to be bound by them.
I accept sole responsibility for my or my child/ward’s personal possessions and athletic equipment.
I accept all liability for any damage to the playing equipment caused by me or my child/ward’s careless, negligent and/or improper
I understand that my child's photo will be posted on the West Grey Soccer Club website, and could be posted in the newspaper.
I acknowledge that I have read this registration agreement in its entirety and that I have executed this registration agreement voluntarily.
Signature of Participant (If aged18 and over)
Signature of Parent/Guardian (If under 18)
For Use by Club Registrar
Note: Club must retain a copy of the player registration
form and, if requested, must submit form to SWRSA or
the Ontario Soccer Association upon request.
of Birth Date