Registration will be confirmed upon payment remittance of $950 at our office, located at:

376 Centennial Rd
Scarborough, ON
M1C 2A3

Please make cheque payable to Tate Philips.

For further information about payment please contact Germaine at (416) 333-6319

Player Name:
Player Guardian:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Primary Phone:
Secondary Phone:
E-mail:
Verify E-mail:
Date of Birth:
Height:
Weight:

Jersey Size: S M L XL XXL

Jersey Number:#1 #2 #3

Position: Forward Defense Goal




Security Code: