Pickering Football Club Team Event Registration Form

Pickering Football Club Team Event Registration Form
Pickering Football Club Inc.

1975 Clements Road, Pickering, ON, L1W 4C2

Telephone: 905-831-9803 / Fax: 905-239-0067

Web Site: www.pickeringfc.ca
Team Name
Date of Proposal

MonthDayYear
Date
Age Group
Gender

MaleFemaleOther
Coach's Name
Home Number

Area CodePhone Number
Cell Number

Area CodePhone Number
Email
example@example.com
Event Name
Event Date

MonthDayYear
Date
Event Location
Briefly Describe the Event
How Many People do You Expect to Attend
Please Document Carefully the Measures That Will be Taken to Ensure the Safety of the Participants?
Does the venue require proof of insurance? If so, fill in the OSA form at this link. http://www.hkmb.com/library/OSACertificateofInsuranceRequestForm-2010_000.pdf

YesNo
I have verified that the above information is correct (Signature)

Clear
A copy of this application will be sent to your email as soon as possible.
Should be Empty: