Local Weekend College Combine Registration for American (U.S) Players Register for the Local Weekend College Combine Step 1 of 5 20% Local Weekend College CombineUse this application to register for the BDA Weekend USA Showcase. This form is for AMERICAN (U.S.) PLAYERS ONLY. Do you currently have a BDA Loyalty Membership?*YesYes, but it is expiredNoA $200 membership renewal fee will be added to your registration fee.Loyalty Membership Number*Please enter your membership card number.If you're not a member of our Loyalty Program, a $120 USD fee will be added to your registration fee.Would you like to get a BDA Loyalty Program Member?*YesNoNOTE: Being a Loyalty Member gets you a discount for this event and many other events. You will also enjoy other Member's Only Perks! COST: $500 Player's InformationPlayer's Name* First Last Player's Cellphone Number*Player's Email Address Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Player's Date of Birth* Date Format: MM slash DD slash YYYY Player's Gender*FemaleMalePrefer not to discloseShirt Sizing*Youth MediumYouth LargeYouth X-LargeAdult SmallAdult MediumAdult LargeAdult X-LargeFlip Flop (Slider) U.S. Size*Previous Playing ExperienceClub*Age Group*League* Parents / Guardians InformationMother's Name* First Last If not available, please type N/AMother's Cellphone Number*If not available, please fill with zerosMother's Email Address Father's Name* First Last If not available, please type N/AFather's Cellphone Number*If not available, please fill with zerosFather's Email Address Terms and Conditions I authorize the Toronto Blizzard Academy to collect and use personal information about me for the purpose of receiving communications from the Canadian Universities and Colleges, American Universities and Colleges, League and Soccer Organization. I understand that I may withdraw such consent related to receiving communications at any time by contacting the Blizzard Development Academy Privacy Officer at by mail to Attention: Privacy Officer, Toronto Blizzard, PO Box 155, Kleinberg ON L0J 1C0. The Privacy Officer will advise the implications of such withdrawal. Please Note: We do not sell or distribute your personal information to any other third party not listed herein. In consideration of the acceptance of my or my child/ward’s membership in the Blizzard Development Academy, I, the participant, agree as follows: I have read and understand the waiver attached and my signature affixed hereto indicates my agreement with such waiver. I am aware of Toronto Blizzard bylaws, policies, rules and regulations and agree to abide by them and to be bound by them. I accept sole responsibility for my personal possessions and athletic equipment and accept all liability for any damage to the playing equipment caused by my careless, negligent and/or improper handling. I grant permission to the Toronto Blizzard to photograph and/or record my image and/or voice on still or motion picture film and/or audio tape and to use this material to promote the sport of soccer and the Organizations through the media of newsletters, websites, television, film, radio, print and/or other form. I understand I waive any claim to remuneration for use of audio/visual materials used for these purposes. By signing and dating below you agree that you are the player being registered and to be bound by this Legal Agreement even if you have not read this agreement. Terms and Conditions I have read and accept the Terms and Conditions as stated above. Required Documents* I have completed all required documents Registrant’s inital or Parent/Legal Guardian if under 18*Date of Inital* Date Format: MM slash DD slash YYYY Email Address* Please enter an email address to receive the confirmation email. Payment InformationNew BDA Loyalty Program Membership* Price: $500.00 Membership Renewal - BDA Loyalty Program* Price: $200.00 Local Weekend College Combine* Price: $89.00 NON BDA Loyalty Program Member fee* Price: $120.00 Payment Method*Please select your payment methodCredit CardPaypalInterac e-TransferCash/ChequeTransaction Fee* Price: $7.00 A 3.5% transaction fee will be added when paying with Credit Card or PaypalTotal $0.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Cheque Payment Please make the cheque payable to Toronto Blizzard Academy e-Transfer (Interac) Please e-transfer the total amount to [email protected] Cash Please submit the form and send an email to Joe Parolini ([email protected]) with your registration details. Local Weekend College Combine Hosted by Toronto BlizzardJan 31st, Feb 1st, & Feb 2nd, 2020(Combine – 10 Hours)Wild Water Kingdom, 7885 Finch Ave. W, Brampton