Adult League SHERWOOD PARK DISTRICT SOCCER ASSOCIATION
Recreation 2012 - 2013 Indoor Season
131, 2000 Premier Way, Millennium Place, Sherwood Park AB, T8H 2G4 Tel: (780)449-1343, Fax: (780)464-5821 web: www.spdsa.net
**PLEASE READ CAREFULLY AND FILL IN ALL THE BLANKS**
SPDSA accepts registrations for the Adult league by team basis. SPDSA will accept individual applications
and try it's best to place individuals on teams where possible.
PLAYER INFORMATION Month Day Year
Last Name: Birthday:
First Name: Birth Cert.Reg.#:
City: Gender: Male Female
Postal Code: Email:
Home Phone: 780- Work Phone : 780-
Cell Phone : ________________________________
SPDSA respects your privacy and are committed to protecting the personal information you share with us.
Please advise of any special needs or allergies
Team Registering For:
Division Playing In:
If you were last registered on a team outside Sherwood Park, a letter of release indicating that you have no outstanding suspensions or fines is required
from your previous CSA Affiliate prior to the acceptance of this registration. If you last played with another Association other than SPDSA (Sherwood
Park District Soccer Association) indicate which team (City & Province) and season last played.
Team:__________________________ City:_______________________________ Province:___________________________
Consent, Release and Waiver:
I hereby give my consent to participate in the Association’s programs, that I may travel by private or public transport to participate in soccer activities outside
Sherwood Park. I am aware that the registration fee covers only the cost of house league play. It does not cover the costs of tournament travel or play. I will
advise team coach, in writing, of any infirmity, medication, or other information in ensure his/her good health and happiness. I accept full responsibility for and
injuries I may receive. I understand that I cannot register for another soccer association while registered with SPDSA. I understand that I may be in pictures
posted on the web site. Insurance for participation in these activities is limited to the extent of my ASA coverage and my membership therein through this
registration. Photos may be taken at events for promotional purposes. Should personal information be collected through program registrations or other forms,
it is done under authority of the Freedom of Information and Protection of Privacy Act, Section 33c and is used to administer programs and services.
I have read and fully understand the above.
Player Signature(Parent if Minor):_____________________________________ Date: