Fill in the form below to Register for the Season
Registering for - Burnaby Selects U:
Date of Birth:
Player First Name:
Player Last Name:
Phone Number: *
Team & Club Last Played For:
Guardians First Name:
Guardians Last Name:
Guardians Phone Number:
Guardians Home Address:
Guardians Postal Code:
Guardians Email Address:
Registration Fee (U13 to U18) $290.00
Add $20 for payments after July 1st.
Includes Shorts ans Socks
I Wish to Pay For My Registration By (Cash/Cheque/Financial Aid Needed):
I, the parent/guardian hereby consent to the player participating in the soccer program of the Burnaby Metro Selects Soccer Club (the "club"), a society incorporated under the British Columbia society act, In consideration of the club accepting the players registration and allowing the player to participate in the activities of the club. I agree that I will not hold the club or any of its directors, officers, members, coaches, managers, employees, workers or volunteers (collectively, the "released parties") liable or responsible in any manner whatsoever for any injuries, losses or damages that may be suffered or incurred by the player during or as a result of the players participation in any games, practices or any other activities of the club, including those injuries, losses or damages that may occur as a result of the negligence of the club or any of the released parties.
By agreeing to this application, you are consenting on your behalf and on the behalf of your child to the collection, use, and disclosure of your personal information for the purpose of the BC Soccer Association, the District Soccer Association, Burnaby Metro Selects Soccer Club and the league which they play in. The personal information you provide will be used for purposes reasonably associated with your child's enrollment as a soccer player to obtain insurance. The personal information will not be disclosed to third parties other than as stipulated unless required by law.
Spam Protection: Please don't fill this in: