Royal City Hyacks Football Club - 2010 Player Registration
Only those fields marked with an
*
are required.
Player Information
Player's Name
*
First
Last
Gender
*
Male
Female
CareCard Number
*
Birth Date
*
MM
/
DD
/
YYYY
Address
*
Address
Anmore
Burnaby
Coquitlam
Delta
Langley
Maple Ridge
New Westminster
North Vancouver
Pitt Meadows
Port Coquitlam
Port Moody
Richmond
Surrey
Vancouver
West Vancouver
White Rock
Other
City
Postal Code
Home Phone Number
*
###
-
###
-
####
Which school does this player attend?
*
Connaught Heights Elementary
F.W. Howay Elementary
Glenbrook Middle School
Herbert Spencer Elementary
Hume Park Elementary
John Robson Elementary
Lord Kelvin Elementary
Lord Tweedsmuir Elementary
Queen Elizabeth Elementary
Queensborough Middle School
Richard McBride Elementary
New Westminster Secondary
Community Education
Home Learners Program
Other - Preschool
Other - Private
Other - Public
Do you grant permission for this child's photo to be published by the RCHFC?
Yes
No
Was this player registered with another team in the VMFL in 2009 (other than with us)?
No
Yes
What previous football or sports experience does the player have? What other activities (athletic and otherwise) is this player currently involved in?
Guardian Information
Name
*
First
Last
Address
*
Address
Anmore
Burnaby
Coquitlam
Delta
Langley
Maple Ridge
New Westminster
North Vancouver
Pitt Meadows
Port Coquitlam
Port Moody
Richmond
Surrey
Vancouver
West Vancouver
White Rock
Other
City
Postal Code
Home Phone Number
*
###
-
###
-
####
Alternate Phone Number
###
-
###
-
####
Cell
Work
Pager
Other
Type
Email Address
*
Alternate Email Address
RCHFC Membership
Please consider me for membership in the RCHFC organization. This will give me one vote at the annual AGM. (A membership in our association is available to one parent/guardian of each player registered.)
Other Guardian / Emergency Contact
Optional
Name
First
Last
Address
Address
Anmore
Burnaby
Coquitlam
Delta
Langley
Maple Ridge
New Westminster
North Vancouver
Pitt Meadows
Port Coquitlam
Port Moody
Richmond
Surrey
Vancouver
West Vancouver
White Rock
Other
City
Postal Code
Home Phone Number
###
-
###
-
####
Alternate Phone Number
###
-
###
-
####
Cell
Work
Pager
Other
Type
Email Address
Alternate Email Address
Waiver
I/We hereby approve and consent to the player being registered to participate in the Royal City Hyacks Football Club football program and absolve and release the Royal City Hyacks Football Club, the City of New Westminster, School District No. 40 (New Westminster), Football BC and any of their affiliate associations, members or volunteers from any and all liability arising from any act or omission on their part resulting in injury, fatality or illness occurring as a consequence of said participation. I/We agree to abide by the Policies, Procedures and By-Laws of the Royal City Hyacks Football Club.
Questions
How would you like to pay for this registration?
*
Credit Card (via PayPal)
Cheque/Cash
Financial Assistance Required
How did you find out about Hyacks Football?
*
Active Living Guide Ad
Community event
Newspaper Ad
Newspaper Article
Played football last year
Poster
Recommendation from a friend or another family
School flyer or visit
Sign
Website
Word of mouth
Other
Are you willing to volunteer in one of the following capacities?
Experience is not required, as we have training for all of these roles.
Coach
Team Manager
First Aid
Equipment Manager
Comments