Fall & Winter Program

Youth Registration

Registration for our 10-week Youth Program is open.

The program is $175, taxes included.

Once registered and paid, there are no refunds, so please ensure you are sure of your decision to participate.

Fields marked with an * are required.

Athlete

Athlete's First Name *

Athlete's Last Name *

Registration Zone *

Athlete's Gender *

M F

Athlete's Age *

Athlete's Birthday *

T-Shirt Size *

Parent/Guardian

Parent/Guardian Name 1 *

Parent/Guardian Name 2

Address *

Village, Town or City *

Province *

Postal Code *

Home Phone *

Cell Phone

Email *

Alternate Email

Emergency

Emergency Contact Name *

Emergency Contact Phone *

Please let us know about any medical issues or chronic injuries.

Waiver & Release

Note: Please read the Waiver of Liability and Release carefully to ensure full understanding.

I, a Participant in Cumberland Sporting Club (CSC) events, activities and programs, in consideration for my voluntary participation in CSC events, activities and programs, acknowledge that I understand and agree as follows:

CSC events, activities and programs include among others futsal, running and soccer programs. These physical sports involve the risk of injury.
I agree: a) To assume all risks arising out of, associated with or related to my participation; and b) To release CSC from liability for any and all claims, that might arise out of my participation.
I consent to be contacted by CSC and its employees by way of electronic mail, telephone, and social media.
I authorize my photograph, or likeness, and voice to appear in any promotion or video (including advertising) of CSC events, activities and programs, without notice or compensation.

Acknowledgement *

All Cumberland Sporting Club participants are legal minors and their parents, natural guardians or legal guardians must read and sign the following acknowledgement on their behalf.

As the parent and natural guardian or legal guardian of the Participant, I hereby agree to the foregoing Waiver of Liability and Release for, and on behalf of, the Participant named in the above registration form.

Atlantic Futsal Privacy Policy

For your information, please download our privacy policy.

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Contact Us

Cumberland Sporting Club:

PO Box 542
Amherst, Nova Scotia
Canada B4H 4A1
info@cumberlandsc.ca