PAC | “lil” Championz League – LevelUp Marketing Solutions

Please Select The League*
- U3-U4 "lil" Championz League co-ed
- U5-U6 "lil" Championz League co-ed
- U7-U8 "lil" Championz League Girls
- U7-U8 "lil" Championz League Boys
Select U5-U6 Team*
Select Girls U7-U8 Team*
Select Boys U7-U8 Team*
March 19, 2022: 10:00 am - 11:00 am, March 26, 2022: 10:00 am - 11:00 am, April 2, 2022: 10:00 am - 11:00 am, April 9, 2022: 10:00 am - 11:00 am, April 16, 2022: 10:00 am - 11:00 am, April 23, 2022: 10:00 am - 11:00 am, April 30, 2022: 10:00 am - 11:00 am
March 19, 2022: 12:00 pm - 1:00 pm, March 26, 2022: 12:00 pm - 1:00 pm, April 2, 2022: 12:00 pm - 1:00 pm, April 9, 2022: 12:00 pm - 1:00 pm, April 23, 2022: 12:00 pm - 1:00 pm, April 30, 2022: 12:00 pm - 1:00 pm
March 20, 2022, March 27, 2022, April 3, 2022, April 10, 2022, April 16, 2022, April 23, 2022, April 30, 2022
Participant Information
Participant Name*
First Last
Participant Date of Birth*
MM
DD
YYYY
Gender*
Name of School/Centre
Parent/Guardian Information
Parent/Guardian Name*
First Last
Parent/Guardian Phone Number*
Parent/Guardian Email Address*
Parent/Guardian 2 Name
First Last
Parent/Guardian 2 Phone Number
Parent/Guardian 2 Email Address

Emergency & Medical Contact Information
EMERGENCY CONTACT
In an emergency, when parents cannot be reached, please contact:
Primary Emergency Contact Name*
First Last
Primary Emergency Contact Relationship to Player*
Primary Emergency Contact Phone Number*
Secondary Emergency Contact Name
First Last
Secondary Emergency Contact Relationship to Player
Secondary Emergency Contact Phone Number
MEDICAL HISTORY
If the answer to any of the following questions (below), is yes, please describe the problem and its implications for proper first aid treatment within the registration.
Does the player have any allergies that we need to be aware of?*
- Yes
- No
Please list all the allergies below*
Does the player have any other medical conditions that we need to be aware of?*
- Yes
- No
Please list all the medical conditions that we need to be aware of in the text box below.*

Participant Information