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Programs
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Programs
Program Registration
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Program Selection
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Aqua Go Sunday at Trent 6-7
Aqua Go Sunday at Wellness Center 4-5
Mini's Sunday Well Center 3:30-4
Masters Rec Trent 7-8
Masters/Teen Experience Level
Beginner
Intermediate
Advanced
Swimmer's Information
Swimmer's Name
*
First
Last
Swimmer's Date of Birth
*
MM slash DD slash YYYY
Swimmer's Address
*
Street Address
Address Line 2
City
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Does Swimmer Wear a Medic Alert Bracelet?
*
Yes
No
Other medical problems or conditions which may require attention, including allergies:
Parent/Guardian/ or YOURSELF for Masters Registration
Parent/Guardian Name
*
First
Last
Relationship to Swimmer
*
Primary Phone No.
*
Mobile Phone No.
*
Email
*
Enter Email
Confirm Email
Additional Parent/Guardian
Parent/Guardian Name
First
Last
Relationship to Swimmer
Primary Phone No.
Mobile Phone No.
Email
Enter Email
Confirm Email
Emergency Contact #1
Name
*
First
Last
Relationship to Swimmer
*
Primary Phone No.
*
Mobile Phone No.
*
Emergency Contact #2
Emergency Contact (#2) Name
First
Last
Relationship to Swimmer
Primary Phone No.
Mobile Phone No.
Kawartha Artistic Swimming Registration Waivers & Releases
Understanding of Kawartha Artistic Swimming Program and Commitments:
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I have read and agree to the following:
I (Athlete or Athletes Parent/Guardian if under 18 years of age) are aware of the policies of the Kawartha Artistic Swimming (KAS), and that I (Athlete or Athletes Parent/Guardian if under 18 years of age) agree to accept these policies as written and any commitments set out in this document, financial and otherwise.
Consent for Emergency Medical Treatment
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I have read and agree to the following:
I, (Athlete or Athletes Parent/Guardian if under 18 years of age), give permission to the members and staff of Kawartha Artistic Swimming, and the officials and coaches of Ontario Artistic Swimming (OAS) to make decisions concerning medical care and treatment, and where necessary to authorize such care and treatment in emergency situations. I understand that the officials and coaches of OAS and Kawartha Artistic Swimming will make every reasonable effort, in the circumstances, to contact me regarding my child’s medical status in the event an emergency arises. In the event that I cannot be reached in an emergency I hereby give my permission to the licensed physician, dentist, athletic therapist, nurse or other medical professional whose services might be required to provide medical care and treatment. Acknowledging this waiver, I indicate that I have the understanding and capacity to communicate health care directives for my child/ward and that I am fully informed as to the contents of this document and understand the full import of this grant of powers to the members and staff of Kawartha Artistic Swimming and the officials and coaches of OAS.
Acknowledgement of Risk in Sport
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I have read and agree to the following:
I participate in the sport of artistic swimming because it is physically and mentally challenging. In consideration of my participation in such programs, activities and events, and by keying in my initials in the online registration form, I hereby acknowledge that I am aware of the risks and hazards associated with or related to artistic swimming.
The risks and hazards of artistic swimming include, but are not limited to:
• Injuries from executing strenuous and demanding physical techniques in artistic swimming including boosts and lifts;
• Injuries from dry-land training including weights, Pilates, running, dance, bands, circus school and massage;
• Injuries from entering the water by either diving or jumping;
• Injuries from spending extended times in chlorinated water including bacterial infections and rashes;
• Injuries from collisions with the pool wall or pool bottom;
• Injuries from extended time underwater;
• Injuries from physical contact with other participants including spotters whose role is to enhance safety and learning;
• Injuries from strenuous cardioviral workouts;
• Injuries from exerting and stretching various muscle groups; and
• Travel to and from competitive events and associated non-competitive events, which are an integral part of the organization’s activities.
Furthermore, I am aware that:
• Injuries sustained in artistic swimming can be severe;
• I may come into close contact with other participants, including the possibility of accidental and unexpected touching;
• I may experience anxiety while challenging myself during the activities;
• My risk of injury is reduced if I follow all rules adopted during training; and
• My risk of injury increases as I become fatigued. I am participating voluntarily in these activities, events and programs.
I (Athlete or Athletes Parent/Guardian if under 18 years of age) agree that there are risks in artistic swimming as described above. By participating voluntarily in these events, activities and programs, I am exposed to these risks and hazards. I agree to accept them and be responsible for any injury or other loss which I might receive while participating in these events, activities and programs. If something happens to me, I release the organizers of responsibility for any claims, demands, actions and costs that might arise out of my participation. In this Agreement I understand “organizers” to mean: Ontario Artistic Swimming (OAS), its directors, officers, members, employees, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of the facility, and representatives.
Kawartha Artistic Swimming Social Media, Photograph and Information Permission
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I have read and agree to the following:
I (Athlete or Athletes Parent/Guardian if under 18 years of age) authorize Kawartha Artistic Swimming and Ontario Artistic Swimming to permit photographers/videographers employed or designated by Kawartha Artistic Swimming and Ontario Artistic Swimming to take photographs and/or film/video footage of and to obtain quotations and information from the undersigned.
Such photographs, film/video footage and recorded comments may be used for educational purposes, publications and/or broadcasts which may include but not limited to the following: newspapers, radio, television, staff newsletters, photographic displays, social media and publicly distributed publications such as annual reports, external newsletters, news releases, pamphlets, brochures, websites, flyers and promotional publications and the undersigned shall be entitled to no compensation as a result of such use from Kawartha Artistic Swimming or Ontario Artistic Swimming.
The athlete shall be entitled to no compensation as a result of such use from Kawartha Artistic Swimming, OAS or CAS. It is recognized by the registered athlete or, for minor athletes, their parents that given the nature of the sport of Artistic Swimming and the nature of the events, water shows and competitions that Kawartha Artistic Swimming and/or OAS and/or CAS cannot be held responsible for the outcomes related to the use/publication of photos/videos, especially by those not employed or designated by Kawartha Artistic Swimming and/or OAS and/or CAS.
Agreement to Receive Electronic Communication
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I have read and agree to the following:
I (Athlete or Athletes Parent/Guardian if under 18 years of age), agree to receive electronic communications from Ontario Artistic Swimming and member clubs including Kawartha Artistic Swimming. Electronic communications include newsletters, promotions and program and event information that may contain information of a commercial nature. I understand that if I no longer wish to receive electronic communications from Ontario Artistic Swimming or Kawartha Artistic Swimming, I can withdraw my consent at any time using the process set out in the Ontario Artistic Swimming Policy.
For more information on how Ontario Artistic Swimming uses electronic communications, refer to the Privacy Policy at www.ontarioartisticswimming.ca
Agreement of Kawartha Artistic Swimming Policies
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I have read and agree to the following:
I (Athlete or Athletes Parent/Guardian if under 18 years of age), have read and agreed to the following:
KAS’s
Concussion Policy, Policies and Insurance
KAS’s
Competitive Program Policy
(if applicable)
KAS’s
Refund Policy
KAS’s
Fundraising Policy
Mandatory Delta Bingo & Gaming Commitment
*
I have read and agree to the following:
Annual registration fees are substantially subsidized by Delta Bingo & Gaming.
All Regional League & Provincial Competitive families will require a parent/guardian of a swimmer to commit to volunteering for assigned shifts at Delta Bingo and Gaming Centre.
The number of volunteer shifts will be determined based on the number of competitive/regional league swimmers.
Please note, this commitment is vital to the success of our club.
How did you hear about us?
*
Referral
Facebook
Brochure at Wellness Center
Signage
Other Social Media
Radio Ad
Girl Guides
Other/Swam Last year
Referred By:
Name
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