Fortius Sport & Health
Burnaby, B.C.


Full Time Program

Soccer Camps

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Try Out Registration Form

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

Player Information

Trying Out As:*
Home Phone Number:*

Parent/Guardian Information

Name of Parent 1:*
Cell Phone Number - Parent 1:
Name of Parent 2:
Cell Phone Number - Parent 2:

Additional Information

Recommended to program by:
Where did you hear about our program?*
District Player is In:
Name of Current Soccer Club:
Activity on other training days (fitness, other sports, etc):
Does the player currently train with another soccer program other than his/her club team?
If yes, what current soccer program?
In the past has the player trained with any other soccer program other than his/her club team?*
If yes, what previous soccer program?
Sign me up for your online e-mail list and keep me up to date on all upcoming events*

£  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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