Registration Form
To register, please phone, fax, email or mail the below information to John Berzolla.
Phone: (306) 664-7275 [work] (306) 343-7073 [home]
Fax: (306) 664-7333 [work]
Mailing address: 5 - 419 Ludlow Street Saskatoon, SK. S7S 1P3[work]
Email: saskatoonsoccerconditioning@yahoo.com
If you have any questions, please contact John Berzolla at the above contact information.
All starred areas (*) must be filled out to complete registration form.
Is this a team entry ___ or individual player entry ___? (*Check one)
Team entry __
*Team name: ____________________________________________
* League (i.e. Saskatoon Youth) and Division: __________________
*Age range of players: _________
*Sex: ______________________
*Contact Person: __________________________
*Relationship (i.e. coach): ____________________
*Address: ________________________________
*Postal Code: ____________
*Phone: (____)______-_______________
Fax (____) _________-_______________
Email: ____________________________
Preferred method of correspondence: __ Mail __ Fax __ Email __Phone
How did you find out about SSC? _____________________________
or
Individual Player Entry ___
*Player's name: ____________________________________________
* League (i.e. Saskatoon Youth) and Division: __________________
*Age: _________
*Sex: ______________________
*Contact Person: __________________________
*Relationship (i.e. self, parent): ____________________
*Address: ________________________________
*Postal Code: ____________
*Phone: (____)______-_______________
Fax (____) _________-_______________
Email: ____________________________
Preferred method of correspondence: __ Mail __ Fax __ Email __Phone
How did you find out about SSC? _______________________________
DISCLAIMER: John Berzolla, the Saskatoon Soccer Conditioning (SSC) program, and the owner/operator of the field or gymnasium in which the program occurs are not responsible for any injuries or losses that occur during or in relation to the soccer conditioning program. Payment will be required at the first day of the soccer conditioning program. Cash or cheque will be accepted, with a 15% additional charge for any NSF cheque. Final fees will be determined by the SSC program staff and a receipt will be provided on the first day of the program. Registrations will be processed on a first-come, first-served basis. SSC will contact the contact person listed on the registration form to confirm registration.
***I, ________________________________ (name), have read and do understand the above disclaimer, and agree to the terms of the disclaimer.
Signed: _________________________________
Date: ___________________________________
In case of an emergency on behalf of myself, SSC should contact:
_______________________________________________________________________
Relationship of contact to participant (ex. parent): _________________________________
Contact's phone numbers (work, home, and/or mobile):____________________________
_______________________________________________________________________
