2010 REGISTRATION FORM

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NAME OF PLAYER                     

                                                                                                                      
PARENTS OR GUARDIANS NAME(S)

                                                                                                                      
ADDRESS

                                                                                                                     
CITY                                         PROVINCE                    POSTAL CODE

                                                                                                                     
HOME PHONE                                                         BUSINESS PHONE

                                                                                                                        AGE                                  POSITION                     CLUB TEAM

                                                                                                                     
COACH                                                                  COACH’S PHONE NUMBER

                                                                                                                     
HEALTH CARD NUMBER                                    EMAIL ADDRESS

CIRCLE DESIRED SESSIONS:

LADY LYNX:

SESSION:               1        2                      

LYNX:

SESSION:               1        2                      

CIRCLE METHOD OF PAYMENT:

CHEQUE                                   MASTERCARD                            VISA

                                                                                                                   
CREDIT CARD NUMBER                                 EXPIRY DATE

                                                                                                                    
NAME ON CARD                                            SIGNATURE

100 Westmore Drive, Suite 8, Toronto, Ontario, Canada M9V 5C3

Main Line: (416) 251-4625 x 23  Fax Line: (416) 946-1899  e-mail: camps@lynxsoccer.com

* The Toronto Lynx reserve the right to cancel or alter dates of sessions as required.