Team Player Registration - Competitive Edge Physiotherapy

General Info*
- Male
- Female
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Daytime Phone*
Cell Phone*
Email*
Address*

(House #, Street Name, City, Province, Postal Code)
Emergency Contact*
I agree to release and waive all claims and hereby indemnify and hold harmless the Corporation of Competitive Edge Physiotherapy and Sport Conditioning (CE) and its elected officials, officers, employees, agents representatives, volunteers and other participants (“The Indemnified Persons”) for a any and all liability for any property damage or personal injury resulting to me or to any of the above-named person(s) for whom I am in law responsible, from or connected with participation in any activity contemplated by this Registration. I hereby further agree that CE and the Indemnified Persons shall not be liable, either directly or indirectly, for any claims, or damage, costs and expenses respecting any act done in good faith, including but not limited to personal injury, death, property damage or loss resulting from or connected with participation in any activity contemplated by this Registration. I have read and understood the Waiver of Liability*
- Yes
- No
Past / Present Injuries
Age group(ie 2009) / Team*
Coach's Name*
Player Fee
Price:
Payment can be made by E-transfer to [email protected] or by Credit Card over the phone or in person
Payment
- E-Transfer ( [email protected]) - **Please indicate players name
- Credit Card ( Visa, MC ) 905-997-5093