Player's First Name * Player's Last Name * School Player Attends * Please list any medical conditions or allergies that coaches should be aware of. Contact information for Primary Parent/Guardian Physical Address * Mailing Address (if different than physical address) City * Province * Postal Code * Primary Contact Phone Number * Alternate Phone Number Email * Secondary/Alternate Parent/Guardian Secondary/Alternate Phone Number * Secondary/Alternate Email Volunteering
Volunteers are needed for Coaching, Refereeing, Canteen, Grounds Crew and for the Annual
Tournament. Please indicate where you would like to assist. Adult volunteers require a valid Vulnerable Sector Check on file.
Who would like to volunteer What role(s) would you like to volunteer for Payment
Registration is $40 per player. That registration fee is not being collected until May 1st at the earliest, pending approval of the SDSA Return to Play plan and Ontario Public Health Restrictions. On May 1st, registration fee invoices will be sent to the primary email contact. Electronic payment is available via Interac Email Transfer, and credit card via Paypal.
Please indicate your preferred payment choice. * Consent and Disclosures
Kindly Note – For the 2021 season, siblings in the same age group will be placed on the same team. No player requests for teams or player pairings will be honoured. Players must play in the age appropriate level and cannot be placed in any other division.
South Dundas Soccer's guiding principle is that soccer is accessible and inclusive for everyone, regardless of their ability.
Rowan's Law – Concussion Awareness * Yes, I agree No, I do not agree
I confirm that I have reviewed the
Concussion Awareness Resources as provided by the Ontario government and available on the South Dundas Soccer website at http://www.southdundassoccer.org.
Photography Use *
I hereby permit the use of my child’s team picture or candid sport photos shot on the South Dundas Soccer
Association’s website and/or other promotional material including in any coverage by newspapers or by other legitimate media organizations. All other use of my
child’s picture is prohibited. If no use is checked, it is assumed no consent is given. Please note, this release is for use by South Dundas Soccer and accredited media organizations. South Dundas Soccer is not responsible for photo use by parents or spectators.
Liability Waver * Yes, I agree No, I do not agree
I realize there is potential risk of injury from the activities involved in this program. I knowingly and freely assume all such risks,
both know and unknown. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the South
Dundas Soccer Association, their officers, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of
premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER
CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. As parent/guardian with legal responsibility for this participant, I hereby consent and agree to his/her
release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities
incident to my child’s involvement or participation in the program as provided above.
COVID-19 Declaration and Waiver * Yes, I agree No, I do not agree
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The South Dundas Soccer Association has put in place preventative measures to reduce the spread of COVID-19; however, the South Dundas Soccer Association cannot guarantee that the Participant will not become infected with COVID-19. Further, attending the Activities could increase your risk of contracting COVID-19.
Assumption of Risk Waiver * Yes, I agree No, I do not agree
The registered player is participating voluntarily in the activities and programs of the South Dundas Soccer Association. In consideration of that participation, the parents, legal guardians, and the registered player hereby acknowledge that they are aware of the risks, dangers and hazards and may be exposed to such risks, dangers and hazards. The risks, dangers and hazards include, but are not limited to: Contracting COVID-19 or any other contagious disease; Executing strenuous and demanding physical techniques; Vigorous physical exertion, strenuous cardiovascular workouts and rapid movements; Exerting and stretching various muscle groups; The failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment; Spinal cord injuries which may render the registered player permanently paralyzed; Serious injury to virtually all bones, joints, ligaments, muscles, tendons and other aspects of the registered player body or to the registered player’s general health and well-being; Abrasions, sprains, strains, fractures, or dislocations; Concussion or other head injuries, including but not limited to, closed head injury or blunt head trauma; Physical contact with other participants, spectators, equipment, and hazards; Not wearing appropriate safety or protective equipment, such a helmet; Failure to act safely or within the registered player’s ability or within designated areas; Grass, turf, and other surfaces including bacterial infections and rashes; Collisions with fences, poles, stands, and soccer equipment; Negligence of other persons, including other spectators, participants, or employees; and Weather conditions.