Fortius Sport & Health
Burnaby, B.C.


Full Time Program

Soccer Camps

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Summer Camp 5

Tuesday, August 28th – Thursday, August 31st, 2017

Please complete this registration form in full.
All fields marked with * are required.

Interest in Full-Time Program

Please consider this player for the full-time program:*

NOTE: this is only for players who are SERIOUS about joining the full-time program starting September of this year.
E-mail us regarding specific training days, times and for more details.

Team Registration
If you are registering with your team and/or qualify for a team discount please indicate the age level and name of your team.

Age Level:
Team Name:
Note: Team discounts must be confirmed with us before you qualify for the discount.

Player Information

Home Phone Number:*
Please add me to your e-mail list and keep me updated on all upcoming events:*

Parent/Guardian Information

Name of Mother:*
Cell Phone Number - Mother:
Name of Father:*
Cell Phone Number - Father:
Please make out the tax receipt to:*
Please e-mail the tax receipt to the following e-mail address:*

Additional Information

Special Instructions/Medical Instructions:
What club do you currently play for?
Have you received special soccer training in the past?*
If Yes, with which organization?
Please take a moment to let us know where you heard about us so we can find out where our marketing efforts are most effective:*
Please indicate name of tournament or website or coach/club or player or be specific about other:

£  Liability Waiver*   

By indicating your acceptance you acknowledge the above-named registrant and the parents/guardians hereby agree that the European Soccer School of Excellence will not be held responsible for any accident or loss no matter how it is caused, and agree to release all instructors, staff or sponsors from all claims or damages which may arise as a result of/or by reason of such accident or loss.*

£  Image Rights Waiver*

By indicating your acceptance you understand and agree that the Roman Tulis staff may take photographic or video images of the above-named registrant. You further grant the Roman Tulis School the right to use such image or likeness in all forms and media, in connection with promotion of our program, or the sport of soccer generally.*

IMPORTANT: Before submitting this form, please verify that all information provided is correct and up-to-date.
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