MIFA ALLSTARS TEAM CANADA Registration

Email*

Player Information

First Name & Last Name*

Address*

Address Line 1*

Address Line 2

City*

State or Region*

Country*

Zip*

Phone Number*

Birth Date*

Email*

Jersey Number (not guaranteed)*

Jersey Number Option 2 (not guaranteed)*

Jersey Size*

Position

Medical/Emergency Contact Information

Emergency Contact*

Phone Number*

Relationship to Player*

By submitting this form you confirm that you have read and understood the following: I agree to abide by the rules, Code of Conduct and regulations of MIFA and conduct myself in a sportsmanlike manner during all MIFA programming and events. I agree that the Player named above will not be permitted to participate in any practices or games until an application form and insurance waiver have been signed, all other documentation has been provided, and the required fees paid. I acknowledge that MIFA DOES NOT PROVIDE A REFUND FOR ANY LEAGUE FEES PAID.

Player Information

Medical/Emergency Contact Information

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