Ontario Futsal Cup Registration Form

ONTARIO CLUB CHAMPIONSHIPS

For MEN & WOMEN, BOYS & GIRLS
Futsal Ontario
(Ontario Futsal Association)
invites you to participate in the above tournament:

MEN WOMEN BOYS GIRLS

AGE GROUP: U -
(Please indicate age group)
If you are a senior team please type "OPEN" in the box above

Club Name:
required

Team Name:
required

First and Last Name of Contact:
required

Street Address:
required

Apartment Number:

City/Town:
required

Province:
required

Postal Code:
required

Day Telephone:
required

Evening Phone:

Fax:

Email Address:
required

ALL CORRESPONDENCE OR CONTACT WILL BE MADE TO THE PERSON NAMED ABOVE!

Name of Coach:

Colour of Shirts:
required

Colour of Shorts:
required

Players Name	Shirt N0.	Birthdate
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Additional Comments:

If you have any questions, here's our contact information:

Ontario Futsal Association
Affiliated with the Canadian Futsal Association

71 South Valerie Street,
St. Thomas, Ontario, Canada N5R 1B1
phone 519-631-5852
fax 519-631-8262
email: r.luft@sympatico.ca

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