Maccabi - Elite Soccer Clinics

* Participant's First Name:
* Participant's Last Name:

Contact Information

Survey Questions

* Participant's Gender

Male

Female

* Participant's Date of Birth. Write DOB as (mm/dd/yyyy)

* Parent/Guardian -1 Full Name:

* Parent/Guardian -1 Relation to participant:

* Parent/Guardian 1 Phone number (available during training session):

* Parent/Guardian -1 email:

* Parent/Guardian -2 Full Name:

* Parent/Guardian -2 Relation to participant:

* Parent/Guardian -2 Phone Number (available during training session):

* Parent/Guardian -2 Email:

* Emergency Contact Full Name: (other than a parent/guardian, to use if a parent is not available)

* Emergency Contact Relation to participant:

* Emergency Contact Phone Number (available during training session):

* Please advise if you child has any medical condition(s):

* Please advise if you child takes any medications:

* Please advise if you child has any allergies: (medication, environmental, food)

* 11. Does your child use an EpiPen:

Yes

* Additional information about the participant the coach should be made aware of:

* Program Selection: *Drop-off program only. Parents are not allowed in the gym (School Policy) *A minimum of 8 participants required to run a session. Clinic location - Bialik Viewmount

* Please select your preferred jersey size:

* Please select your preferred short size.

* For socks please select your shoe size:

* Allow Maccabi Canada to add my name to a third-party program/provider that shares the team’s roster, scheduled practices, games and updates. (For example: WhatsApp, TeamSnap)

Yes

* I hereby release Maccabi Canada and Elite Soccer Clinics to use my photograph/video footage for Marketing purposes. I agree to the photo/video release.

Yes

* In the case that Maccabi Canada cancels a program(s), for any reason, and no alternative program is available or agreed upon with the player, a full refund will be issued by cheque and mailed to the address provided on the participant’s registration form. Please allow 6-8 weeks for refunds to be processed. Your refund can be donated back to Maccabi Canada and you will receive a donation receipt for the value of the refund.

I agree to the above policy

* Maccabi Canada reserves the right to cancel any program at any time if they feel it is not safe to continue to run and participate. Safety of the participants, staff and their families is top priority.

I accept Maccabi Canada's position

* Refunds are based on the full fee value of the season. Administration and processing fees of $100 are non-refundable. If a player withdraws up to 14 days prior to the start of the season, the refund will be the full fee less 35% plus the admin fee. If a player withdraws within 14 days prior to the start of the season, the refund will be the full fee less 50% plus the admin fee. If a player withdraws once the season has started, the refund will be the full fee less 75% plus the admin fee. NO REFUNDS after 2 completed team practices. If the player selected the option to pay by installments, all remaining installments will be processed according to the payment plan. Please allow 6-8 weeks for refunds to be processed by cheque.

I agree to the above policy

* How did you hear about the Maccabi Sports Clinics

Current Maccabi program

Elite Soccer Clinics

Friend

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Other Social Media

Payment Information

* * Payment Amount:

$325.00 - Participation fee

* Processing Date:

* Number of Installments:

installments

* Credit Card Type:

* Credit Card Number:

* Cardholder's Name:

* Credit Card Expiration:

By continuing, you acknowledge that your credit card will be charged on a recurring basis for the duration outlined or until cancelled.

Your privacy is important to us, so Maccabi Canada will keep your personal data secure and Maccabi Canada will not use it for marketing communications which you have not agreed to receive. At any time, you may withdraw consent by emailing or by contacting our Privacy Officer. Please see our Privacy Policy