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REGISTRATION FORM FOR THE 2024-2025 SEASON

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Note that all required fields are marked with **

Contact Details

First Name: **

Middle Name:

Last Name: **

Gender: **

Address: **

City: **

Province/State: **

Postal/Zip Code: **

Country: **

Home Phone: **

Mobile Phone:

Work Phone:

Ext.:

Member Since: **

Years Curling Experience: **

Email:

Please enter your email address here. Email is the primary method used to communicate with our members and is only used for that purpose. If you do not have an email address please leave this field blank.

Re-enter Email:

Emergency Contact (If youth, enter parent): **

Emergency Contact Phone Number: **

Date of Birth: **

Youth members are required to enter their full date of birth including the year. If you want to take advantage of any available age discounts you must enter your full date of birth including the year.

Consent to Release Information, Privacy Policy and Anti-Spam Policy

I hereby consent to the use of the personal information provided above by the Club administration. Only my name and phone numbers will be listed in the membership directory and/or website for general member use. This information is intended for the sole use of Club and will not be shared outside the Club.

I have read the details above and I accept ** (Required for all registrants)

Injury Waiver

In consideration of acceptance of this registration by Club ("the club"), I HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE the club and each of its members, officers and employees FROM ANY AND ALL claims, demands, damages, costs, expenses, actions and cause of action, whether in law or equity in respect of death, injury, loss or damage to myself or property, arising or to arise by reason of my participation in the Club, that has not been contributed to or occasioned by any negligent act, by omission or commission, of any of the aforesaid.

I have read the details above and I accept ** (Required for all registrants)

Membership Selection Instructions

Select the membership type first by checking on the approproiate round checkbox. If registering for a membership type that also has league selections please check all the square checkboxes for the leagues in which you wish to play. Please show all team member names for choose your own leagues, each team member must submit their own form. Not on a team? Write assign for the other team members.

Membership Selections (with leagues)

	Youth Membership
		Little Rocks ($50)
		Bantam & Junior ($90)
	Adult Membership
		Women's Club at 7:00 pm (single entry) enter the top two positions you want to play into the convenor notes $140.00 Notes for League Manager (Women's Club):
		Mixed League at 7:00 pm (choose your own team) $100.00 Skip: Vice-Skip: Second: Lead: Alternate:
		Spare to play in up to 10 games this season. 10 spare tickets will be provided for the member to surrender for each game played. $120.00

Membership Selections (no leagues)

Social Member ($100)

Additional Options

Please select the pricing structure that applys to the league selections you have made above.

	Locker Fee ($20)
	Social Fee for Women's Club league ($10)

Discount Options

Early Bird Discount: register early and receive a $10 discount

Other Information

Bus Permission		Yes No
This student ....

Coaching Certificate
Enter the level of your Coaching Certificate

Newsletter		Include on this distribution list
I want to receive the newsletter

Registration Accuracy Confirmation

I hereby confirm that the information I have entered on this form is correct and true. I understand that if I have intentionally entered false information in this form to receive discounts that do not apply to me there will be a $25 administration charge on top of the outstanding membership dues owed.

We accept the following payment methods:
- cash
- cheque
- credit card (in person)
- credit card (online)

If you do not pay online with your registration, you must pay with one of the other payment methods within 7 days after your online registration.

I have read the details above and I accept ** (Required for all registrants)

New Member Sign-up

REGISTRATION FORM FOR THE 2024-2025 SEASON

Enter registration details

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