Location: Varsity Centre Dome
Date: Saturday, November 9th, 2013
Activities offered: Soccer Skills/Testing/Soccer Scrimmage
Required Equipment: The surface is FIFA 2-star turf field. Turf shoes and round cleats are recommended (NO METAL CLEATS). Shinguards, soccer socks, etc are required.
This form must be returned with signatures at registration on Saturday, November 9th, 2013 for participation in the program.
Main Parent/Guardian Contact
Last Name: SAVIDIS First Name: __ JANE
Home Address: _29 COLLEGIATE Avenue, Stoney Creek, Not L8G 3L2____
Phone- Home- 905-664-2301 Phone Cell 905- 515-9693
Last Name: _SAVIDIS-GEORGIOU First Name: RENA
Are there any medical conditions that could be applicable to your child's participation in this activity? ______________________________________________________________________
In the event of an emergency we will make every attempt to contact the parent or guardian listed above. Please complete this information in the event that we are unable to reach the parent/guardian listed above:
Last Name: ______GEORGIOU___________________ First Name: GEORGE
Relationship to child: FATHER__ Phone Number____905-870-4025
INFORMED CONSENT AGREEMENT
I give permission for __RENA SAVIDIS-GEORGIOU___(print name) to participate in the CIS Girl’s Soccer Recruiting Showcase at the University on Saturday November 9th, 2013.
I the UNDERSIGNED hereby acknowledge that certain RISKS OF INJURY are inherent to participation in sports and recreation activities. These types of injuries may be minor or serious and may result from one's actions, or the actions or inactions of others, or a combination of both. I understand that the RULES and REGULATIONS are designed for the safety and protection of participants and hereby undertake to abide by these rules and regulations. I hereby WARRANT that the participant(s) that I am registering are physically fit to participate and understand that the CHOICE to participate brings with it the ASSUMPTION OF THOSE RISKS AND RESULTS which are part of these activities. I agree that THE GOVERNING COUNCIL OF THE UNIVERSITY OF TORONTO or THE FACULTY OF KINESIOLOGY AND PHYSICAL EDUCATION AT THE UNIVERSITY OF TORONTO shall not be liable for any injury to my