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  • Participant Information

  • Parent/Guardian Information



  • Emergency & Medical Contact Information


  • EMERGENCY CONTACT

    In an emergency, when parents cannot be reached, please contact:


  • 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.
  • Registration Fee & Payment Options

  • The program runs on Saturdays from Saturday Nov 13, 2021 – Saturday Jan 15, 2022 (exclusion date Sat. Dec.25/21 & Jan 1/22)

    • 8-weeks: $159.99+ HST

    * Exclusion date Saturday October 9th, 2021

    Available Payment Options are:

    • Credit Card: You will be redirected to the payment page to complete the payment.
    • Interac e-Transfer: please e-transfer the total amount including HST to belinda@brystsoccer.com
  • You will be redirected to the payment page after you submit this form.

  • Please e-transfer the total amount including HST to belinda@brystsoccer.com