The Ontario Soccer Association Multi Player Registration Form

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THE ONTARIO SOCCER ASSOCIATION
MULTI PLAYER REGISTRATION FORM
-
FAMILY CONTACT INFORMATION
Full Name:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
Province
Postal Code
Home Phone:
(
)
Alternate Phone:
(
)
Fax Number:
E-mail Address:
PLAYER INFORMATION #1
Full Name:
Email:
Last
First
M.I.
Sex:
Birth Date:
Proof of Birthdate:
Birth Certificate
Old Card
Other
OSA Registrant Number:
OHIP Number (Optional) :
*OHIP Numbers are optional to collect and an optional field for this form*
TEAM DETAILS #1
Club Registration Number: CD - __ __ - __ __
Club Name: _____________________________________
Season Type: ___ Indoor ___ Outdoor
Player Classification:
Indoor: ___ Mini___ Youth___ Senior___ Pro
Outdoor: __Mini __Youth Competitive __Youth Recreational __Senior Competitive __Senior Recreational __Pro
Team Registration Number: TD - __ __ __ __ - __ __
Team Name: ___________________________________
League Registration Number: L__ - __ __ __ __ - __ __
League Name: __________________________________
Division Registration Number: D __ - __ __ __ __ __ __ - __ __ __ __ Division Name: ________________________
PLAYING HISTORY #1
ATTENTION: The “PLAYING HISTORY” section MUST be completed
– Any person who provides false information
or withholds any of the required information will be suspended from all Ontario Soccer Association activities for one year.
Has the player ever registered to play soccer in another country? ___ Yes ___ NO
If Yes, answer the following questions:
a)
In which country (other than Canada) did the player last register? _____________________________________
b)
With which Club did the player last register in another country?
_____________________________________
c)
In which year did the player last register in another country?
_____________________
_______________
PLAYER INFORMATION #2
Full Name:
Email:
Last
First
M.I.
Birth Date:
Proof of Birthdate:
Birth Certificate
Old Card
Other
Sex:
OSA Registrant Number:
OHIP Number (Optional) :
*OHIP Numbers are optional to collect and an optional field for this form*
TEAM DETAILS #2
Club Registration Number: CD - __ __ - __ __
Club Name: _____________________________________
Season Type: ___ Indoor ___ Outdoor
Player Classification:
Indoor: ___ Mini___ Youth___ Senior___ Pro
Outdoor: __Mini __Youth Competitive __Youth Recreational __Senior Competitive __Senior Recreational __Pro
Team Registration Number: TD - __ __ __ __ - __ __
Team Name: ___________________________________
League Registration Number: L__ - __ __ __ __ - __ __
League Name: __________________________________
Division Registration Number: D __ - __ __ __ __ __ __ - __ __ __ __ Division Name: ________________________
PLAYING HISTORY #2
ATTENTION: The “PLAYING HISTORY” section MUST be completed
– Any person who provides false information
or withholds any of the required information will be suspended from all Ontario Soccer Association activities for one year.
Has the player ever registered to play soccer in another country? ___ Yes ___ NO
If Yes, answer the following questions:
a)
In which country (other than Canada) did the player last register? _____________________________________
b)
With which Club did the player last register in another country?
_____________________________________
c)
In which year did the player last register in another country?
_____________________
_______________

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