John Doe

Soccer Registration

Registration Reference No:

e2d076ab-5683-49d9-bd37-6b900bd674cd

Contact No:

(705) 994-2146

Email:

Address:

588 tenth st

,

Collingwood

L9Y4C1

Date of Birth:

80-06-27

Gender:

Male

Program:

Coed Rec Spring/Summer 2022 , Coed Comp Spring/Summer 2022

Skill Level:

4

Goalkeeper Status:

Goalkeeper

Total Payment Due:

$

$135.00

Emergency Contact

Name:

Melissa Nyhof

Relationship:

Fiancé

Contact no:

Melissa Nyhof