By submitting this form I the parent/guardian of the registrant hereby give my consent for the registrant to participate in the PSA program. I accept full responsibility for any injuries he/she may receive during games or practices and the costs incurred due to injuries., i.e. ambulance, etc. I understand that my child cannot register with another soccer association while registered with the Pembina Soccer Association. I have read and fully understand the above.

By submitting the form, I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of PSA.