Register Please fill out the form below or print the PDF to register your child for one of our programs. Download PDF RM_StatsAthlete’s Information*First Name*Last Name*Birthday*GenderSelect an optionMaleFemale*Athlete’s Cell*Athlete’s Email*Health Card #*ProgramSelect an optionMarch Break CampGirls 3 on 3 D-LeagueMotion D-LeagueSmall Ball / Tiny TikesAthlete Development CampSoccer DevelopmentHealth Information Allergies Yes No Asthma/Respiratory concerns Yes No Blackouts/Fainting Yes No Chest Pain Yes No Diabetes Yes No Epilepsy Yes No Hearing Disorder Yes No Heart Condition Yes No Recurring Headaches Yes No Seizures Yes No Glasses Yes No Contact Lenses Yes No Injuries Yes No Medications Yes No Other (including recent surgery) / Additional CommentsParent/Guardian Information*First Name*Last Name*Address Apt/Unit #*City*Postal Code*Home Phone*EmailEmergency Contact*Full Name*Home Phone*Cell Phone*Motion Ball Sports Association (MBSA) will not be held responsible for any injuries sustained by a player while playing at any facility or programs operated by the MBSA. I/We acknowledge that all intellectual property, rights and ownership of any media taken and any reproduction thereof, arising from any sports of interests, and/or activities will belong to the MBSA. I/We hereby release, discharge and agree to save harmless any MBSA parties from all liability arising in connection with the sports of interest, and/or activity. A fee of $45.00 will be charged for all NSF Cheques. This form must be signed by a parent/guardian if the player is under eighteen years of age. I/We agree to abide by all rules and regulations of the Motion Ball Sports Association.