2017 Fall Indoor Soccer Registration Credit Card Payment

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Fields marked with an * are required

Do not change the division.  The division is calculated based on the player's birthdate.

The (typically) 16 digits on the front of your credit card.
The 3 digit (back) or 4 digit (front) value on your card.
The name printed on the front of your credit card.
The month your credit card expires, typically on the front of the card.
The year your credit card expires, typically on the front of the card.

I hereby register my child and I do understand that there is a potential for injury while participating in the programs offered by your club and I agree to hold harmless, the Toronto Azzurri Soccer Club, The Team, Officials, League or District Associations from any and all injuries sustained while playing for this Club at practices, games and events. For safety reasons, I agree to supply my child with soccer shoes and shin pads, to be worn at all times during play, including practices. I agree to abide by the rules and regulations of the Toronto Azzurri SC, the Ontario Soccer Association (www.soccer.on.ca) and the North York Soccer Association. I also understand that balancing of the teams may take place up to and including the 3rd game of the season. I consent to my child being filmed, audio taped, photographed, interviewed by employees, agents or servants of the Toronto Azzurri S.C. I have read and understand the registration rules published by the Ontario Soccer Association and I agree to release, indemnify, authorize and acknowledge the contents  of this form.