2017 Futsal Registration Form (Owen Sound Minor Soccer)

Print 2017 Futsal Registration Form
Please fill out one form for each child you are registering to play Futsal.
Personal Information
Please fill in all fields.
  1. Street Address, Apt #
  2. City
  3. Example xxx-xxx-xxxx
  4. Example xxx-xxx-xxxx Extxxxx
  5. Confirmation will be automatically sent to this account
  6. RadDatePicker
    RadDatePicker
    Open the calendar popup.
    Select Date
  7. Choose One
  8. OHIP Numbers are optional to collect and an optional field for this form.
  9. If known to registrant
  10. Last, First
  11. Last, First
Registration Details
Please select the division your child will be playing in - Based on the child's year of birth.
  1. (select child's YEAR of birth)
Playing History
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.
  1. CONSENT FOR USE OF PERSONAL INFORMATION

    I authorize the Canadian Soccer Association, Ontario Soccer Association, South West Regional Soccer Association, and Owen Sound Minor Soccer Association to collect and use personal information about my child/ren for the purpose of receiving communications from the Canadian Soccer Association, Ontario Soccer Association, District Association, 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: [email protected] 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**
Volunteers Needed
OSMSA is a non-profit organization and its continued success depends largely on volunteer participation. Would you be willing to volunteer for an of the following?







  1. .
  1. ACCEPTANCE OF TERMS AND CONDITIONS

    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 /guardian (if participant is under 18 years of age), agree as follows:
    1. I understand that I or my child cannot play in any sanctioned soccer game until after this registration form has been entered in The Ontario Soccer Association's computerized registration system. 

    2. I have reviewed the waiver/participation agreement attached and my signature affixed hereto indicates my agreement with such waiver/participationagreement.  

    3.  I am aware of The Ontario Soccer Association, SWRSA, Owen Sound Minor Soccer Association and League bylaws, policies, rules and regulations and agree to abide by them and to be bound by them. 

    4. I accept sole responsibility for my or my child/ward's personal possessions and athletic equipment.

    5.  I accept all liability for any damages to the playing equipment caused by me or my child/ward's careless, negligent and/or improper handling.

    6.  OSMSA and COACHES have established rules for participation. Proper conduct on/or about the playing field must be followed as per OSMSA Code of Conduct. 

ONTARIO SOCCER ASSOCIATION: PARTICIPATION AGREEMENT FOR THOSE UNDER 18 YEARS (Part 1)
By checking in the box below you will waive certain legal rights, PLEASE READ CAREFULLY.
  1. ONTARIO SOCCER ASSOCIATION: PARTICIPATION AGREEMENT FOR THOSE UNDER 18 YEARS  (Part 2)

    In consideration of allowing my minor child/ward to participate in the programs, activities and events of The Ontario Soccer Association, I ASSURE TO YOU THAT:

    1. I am the parent/guardian of the above named participant having full legal responsibility for decisions regarding the above named participant. 
    2. I believe that my minor/ward is physically, emotionally, and mentally able to participate in the programs, activities and events of The Ontario Soccer Association.
    3. I hereby acknowledge that I am aware of the risks and hazards associated with or related to soccer. The risks and hazards include, but are not limited to injuries from:
    a. Executing strenuous and demanding physical techniques in soccer;
    b. Dryland training including weights, running and massage;
    c. Grass, turf and other surfaces including bacterial infections and rashes;
    d. Falls to the ground due to uneven or irregular terrain or surfaces;
    e. Collisions with walls or soccer equipment;
    f. Failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;
    g. Extreme weather conditions which may result in heatstroke, sunstroke, or hypothermia;
    h. Contact, colliding or being struck by other participants, spectators, equipment or vehicles;
    i. Vigorous physical exertion and strenuous cardiovascular workouts;
    j. Exerting and stretching various muscle groups; and 
    k. Travel to and from competitive events and associated non-competitive events which are an integral part of the organizations activities. 
    4. Furthermore, I am aware that my child/ward may:
    a. Sustain injuries in soccer that can be severe, cause spinal cord injuries and even be fatal;
    b. Experience anxiety while challenging himself/herself during the activities, events and programs;
    c. Come into close contact with other participants, including the possibility of accidental and unexpected contact;
    d. Risk of injury is reduced if he/she follows all rules established for participation; and
    e. Risk of injury increases as he/she becomes fatigued.

    I UNDERSTAND AND AGREE, on behalf of myself, my heirs, assigns, personal representatives and next of kin that my signing of this document constitutes:

    5. I am registering my child/ward willingly and my child/ward is participating voluntarily in these activities, events and programs.
    6. I agree that there are risks in soccer as described above and my child/ward will be exposed to those risks and hazards. 
    7. I agree to accept all these risks and hazards and be responsible for any injury or other loss which my minor child/ward might receive while participating in these events, activities and programs. 
    8. If something happens to my child/ward, I RELEASE the Organizers of responsibility for any claims, demands, actions, and costs which might arise out of my child/ward's participation. I understand "Organizers" to mean: The Ontario Soccer Association, District Associations, Leagues, Clubs and their Directors, Officers, Members, Employees, Volunteers, Officials, Participants, Clubs, Agents, Sponsors, Owners/Operators of Facilities, and Representatives. 

    ACCIDENT INSURANCE - Executing this agreement will not preclude you from accident insurance coverage, subject to the terms and conditions of The Ontario Soccer Association's insurance policy. 

Payment Details
Follow the instructions to complete online payment using PayPal, or mail a cheque payable to Owen Sound Futsal to the following address: Owen Sound Minor Soccer Association PO Box 951 Owen Sound, ON N4K 6H6 Please note: Multiple Child Discount applies to U8-U18 HOUSE LEAGUE players only.
  1. Note: You ARE NOT REQUIRED to purchase a non-resident card from the City of Owen Sound for Futsal
Human Validation
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Printed from owensoundminorsoccer.ca on Saturday, October 21, 2017 at 10:32 PM