Emmanuel Baptist Church - Oshawa

Soccer Pre-Registration

• • Name of child (or volunteer)*
    First Name

    Last Name
  • Grade
    This is the grade your child is in currently.
    Grade One

    Grade Two

    Grade Three

    Grade Four

    Volunteer
  • Date of Birth (Players and Volunteers under 18 only)
    DD

    MM

    YYYY
  • Phone Number*
     

    (###)

    -

    ###

    -

    ####
  • Address
    Street Address

    Address Line 2

    City

    Province / State / Region

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country
  • Your E-mail
     
  • Name of parent*
    First Name

    Last Name
  • Shirt Size (Player - youth sizes)
    Small

    Medium

    Large
  • Shirt Size (Volunteer - adult sizes)
    Small

    Medium

    Large

    XL

    XXL

    XXXL
  • I give permission for my child to participate in the clubs sponsored by Emmanuel Baptist Church Oshawa Inc. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Emmanuel Baptist Church or any of its leaders, coaches, assistants or volunteers liable for damages, injuries or loss incurred.
    Yes I agree.
  • We make every effort to take a Club Photo and have that printed and available to you on the last day of soccer. Do we have your permission to take photos of your child for this purpose and to possibly have them on our website? (If no, then please make sure your child does not go with the group on Photo Day. We will announce this day for you).
    Yes

    No
  • EBC runs family programing all year long! Do we have your permission to contact you about upcoming events for all ages?
    Yes

    No
  • How did you hear about LITE Soccer?
    Flyer from School.

    A friend.

    Through another program at EBC.

    Other.
  • What school does your child attend? (This helps us decide where to target our programs).
    College Hill Public School

    Glen Street Public School

    Cannon Public School

    Lake Woods Public School

    Bobby Orr Public School

    Other
• 
  Submit