In the event that a players is injured or falls ills during a practice or game, it’s crucial to be able to reach a parent or guardian in a timely manner. Please fill in the form below for our records.
Name of Child or Children *
Teams/Age Groups *
Birthdates (YYYY-MM-DD) *
Primary Emergency Contact *
Emergency Phone 1 *
Emergency Phone 2 *
Secondary Emergency Contact *
Additional Emergency Contacts and Numbers
Does your child have any known injuries or health conditions? (Explain)
Does your child have any known allergies? (Explain)
Does your child have any history of concussions? (Explain)
Is there anything we need to know about your child’s health?
Serving up youth soccer in Sea to Sky since 1996.
PO Box 1203