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TORONTO LYNX
U20, PDL, W-LEAGUE
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2011
SEASON TRYOUT REGISTRATION |
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Important: Please enter information in ALL fields. |
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Player's Name:
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Address: |
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City: |
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Province/State: |
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Postal Code/Zip: |
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Home Telephone: |
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Cell Phone: |
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Email Address: |
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Birth Date: |
(Month/Year) |
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Current School: |
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NCAA Level:
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Grad Year: |
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Position:
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Coach Name: |
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Coach Email:
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Last Club Team: |
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Please submit a
brief player profile. |
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Please read the waiver before
submitting your registration information.
Agreeing to the terms of this waiver
are required to secure a trial with the Toronto Lynx |
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MEDICAL |
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Recognizing the
possibility of physical injury associated with soccer and in
consideration for the individual organization accepting the
registrant for its programs and activities, I hereby
release, discharge, and/or indemnify the Toronto Lynx and
Premier Soccer Academy, its affiliated organizations and
sponsors, their employees and associated personnel,
including the owners of facilities utilized for the
Programs, against any claim by or on behalf of the
registrant as a result of the registrant's participation in
the Programs and/or being transported to or from the same,
which transportation I hereby authorize. |
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As a Player over
18, I hereby give consent for emergency medical care
provided by an athletic trainer, coach, team manager,
emergency medical technician, nurse, medical treatment
facility, and/or licensed Doctor of Medicine or Doctor of
Dentistry. This care may be given under whatever conditions
are necessary to preserve the life, limb, or well-being of
my dependent. |
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MISCELLANEOUS |
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I understand
that any personal information collected on Toronto Lynx
and Premier Soccer Academy forms is collected and intended
to be used to enable the Toronto Lynx and Premier
Soccer Academy to deliver its programs to its members. My
personal information will be kept secure and will not be
shared with anyone other than those individuals charged with
administering the Toronto Lynx and Premier Soccer
Academy programs or in cases where disclosure is required to
participate in a sanctioned event. |
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I give my full
permission to the Toronto Lynx and Premier Soccer Academy to
use my (and that of the registrant) name, likeness,
photographs, videotapes or other recordings of me (and the
registrant) that are made during my participation in Toronto
Lynx and Premier Soccer Academy events, for promotional
purposes. (You may request an exclusion by sending an email
to admin@torontolynxsoccerclub.com quoting the player name
and reason for exclusion.) |
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I HAVE READ AND AGREE TO THE
TERMS OF THE WAIVER ABOVE
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Please email
admin@torontolynxsoccerclub.com
if you have any questions or to submit your full player profile |
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