Registration

Parent/Guardian 1 First Name(*)

Invalid Input

Parent/Guardian 1 Last Name(*)

Invalid Input

Parent/Guardian 1 Address(*)

Invalid Input

Parent/Guardian 1 City(*)

Invalid Input

Parent/Guardian 1 Zip(*)

Invalid Input

Parent/Guardian 1 E-Mail(*)

Invalid Input

Parent/Guardian 1 Home Phone

Invalid Input

Parent/Guardian 1 Cell Phone

Invalid Input

Secondary parent/guardian information is optional. Providing e-mail address and cell phone numbers to aid in club communications.

Parent/Guardian 2 First Name

Invalid Input

Parent/Guardian 2 Last Name

Invalid Input

Parent/Guardian 2 Address

Invalid Input

Parent/Guardian 2 City

Invalid Input

Parent/Guardian 2 Zip

Invalid Input

Parent/Guardian 2 E-Mail

Invalid Input

Parent/Guardian 2 Home Phone

Invalid Input

Parent/Guardian 2 Cell Phone

Invalid Input

Player 1 Information

Player First Name(*)

Invalid Input

Player Last Name(*)

Invalid Input

Gender(*)

Invalid Input

Player Birth Date(*)

/ / Invalid Input

Player 2 Information

Player First Name

Invalid Input

Player Last Name

Invalid Input

Gender

Invalid Input

Player Birth Date

/ / Invalid Input

Player 3 Information

Player First Name

Invalid Input

Player Last Name

Invalid Input

Gender

Invalid Input

Player Birth Date

/ / Invalid Input

Player 4 Information

Player First Name

Invalid Input

Player Last Name

Invalid Input

Gender

Invalid Input

Player Birth Date

/ / Invalid Input

Player 5 Information

Player First Name

Invalid Input

Player Last Name

Invalid Input

Gender

Invalid Input

Player Birth Date

/ / Invalid Input

I certify as the submitting parent/guardian that I and my child(ren) have read the CASL Concussion Release document and acknowledge the risk in playing soccer.(*)

Certified

Invalid Input

I certify as the submitting parent/guardian that I and my child(ren) have read the LSC Parent and Player Expectations document and agree to abide by its guidelines.(*)

Certified

Invalid Input

2022-23 LSC Registration