John Doe

Soccer Registration

Registration Reference No:

ab9c7354-3345-4f9e-87b3-5709842faff1

Contact No:

(416) 892-3792

Email:

Address:

13 Park Rd

,

Collingwood

L9Y3B8

Date of Birth:

88-07-11

Gender:

Male

Program:

Coed Rec Pick-up, Winter 2022-23

Skill Level:

1

Goalkeeper Status:

Midfielder

Total Payment Due:

$

$140.00

Emergency Contact

Name:

Isabella Lehmann

Relationship:

Mother

Contact no:

Isabella Lehmann