Victoria Soccer Club - 2021 Indoor U15/U19 Registration

14025 - 142 Street NW, Edmonton Alberta, T6V1H8

Phone: 780-457-3759 vicclub@telusplanet.net

www.victoriasoccerclub.com

Player First Name*

Player Last Name*

Age Group*

Male

Female

Address*

City*

Postal*

Birthdate*

Home Phone*

Email*

Guardian 1

Guardian 1 Cell

Guardian 2 Name

Guardian 2 Cell

Previous Teams Played for

Emergency Contact*

Emergency Contact Phone*

Any known medical conditions

Payment may be made via credit card or cheque delivered to our office, attention Linda, at the address at the top of this page or by providing credit card information below. A receipt will be provide to the email address given above.

Thanks you a receipt will be emailed within 24 hours

Thank you for registering

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Training Top

Shorts

VICTORIA SOCCER CLUB: DECLARATION OF COMPLIANCE COVID 19

Alberta Soccer Association, [Edmonton Interdistrict Youth Soccer Association] and [Victoria Soccer Club] (collectively the "Organization") require the disclosure of exposure to illness in order to safeguard the health and safety of all participants and limit the further outbreak of COVID-19. This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent.

An individual (or the individual's parent/guardian, if the individual is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization's facilities or participate in the Organization's activities, programs, or services.

I, the undersigned being the individual named above and the individual's parent/guardian (if the individual is younger than 18 years old), hereby acknowledge and agree to the terms outlined in this document:

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document.
The individual has not been diagnosed with COVID-19, OR if the individual was diagnosed with COVID-19, the individual was cleared as noncontagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed.
The individual has not been exposed to a person with a confirmed or suspected case of COVID-19, OR If the individual was exposed to a person with a confirmed or suspected case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed.
The individual is attending or participating voluntarily and understands the risks associated with COVID-19. The individual (or the individual's parent/guardian, on behalf of the individual (when applicable)) agrees to assume those risks, including but not limited to exposure and being infected.

We have read and agree to be bound by the above

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Facility Rules/Covid Info