Registration with Cheque PRE-REGISTRATION FORM Please fill out the following registration form and remember to click the SEND button, your confirmation message will be show at the top of the page: PARENT/GUARDIAN Surname (required) Given Name (required) Your Email (required) Phone Number (required) Address PLAYER(S) Player 1 - Full name Gender SelectMaleFemale Age: Select4567891011121314 Birthday: SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day: Select12345678910111213141516171819202122232425262728293031 Year: Select201120102009200820072006200520042003200220012000 Player 2 - Full name Gender SelectMaleFemale Age: Select4567891011121314 Birthday: SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day: Select12345678910111213141516171819202122232425262728293031 Year: Select201120102009200820072006200520042003200220012000 Player 3 - Full name Gender SelectMaleFemale Age: Select4567891011121314 Birthday: SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Day: Select12345678910111213141516171819202122232425262728293031 Year: Select201120102009200820072006200520042003200220012000 REGISTRATION FEE Please type the amount of your payment below Cheque Number Transaction Date 12345678910111212345678910111213141516171819202122232425262728293031202020212022 As parent/guardian of the above player(s), I agree to hold harmless Sports4Life and staff members for injuries and other incidents that may result in my child’s participation in the above activity. Further, I have current medical insurance coverage, agreeing to assume all responsibilities if such expenses arise from injuries sustained in the activity. I also, hereby give my consent to Sports4Life to use my child’s/participant’s images/photos and to be posted on the Sports4Life network and to display his/her name with the associated images or videos. By entering my name below, I agree to the Sports4life Agreement and Waiver Full Name (required)