CCITC NATIONAL "LIVING HEALTHY" SENIOR TEAM TENNIS "DOUBLES" TOURNAMENT
ccitc@cromartytennis.ca [Defunct]
 
VOLUNTARY CCITC "LIVING HEALTHY" TENNIS CLINIC REGISTRATION FORM
 
(PLEASE PRINT ALL INFORMATION)

YOUR LAST NAME: __________________________________________________

YOUR FIRST NAME: ___________________ INITIAL: _______________

YOUR MAILING ADDRESS:  ________________________________________

CITY/TOWN: ______________  PROVINCE/TERRITORY: _________________

POSTAL CODE: _______________________________________________________

HOME PHONE: ___________________   CELL  PHONE: ___________________

YOUR E-MAIL: ______________________________________________________

GENDER: M: ____ F: ____  

AGE AS OF NOVEMBER 19, 2014: ___________

SELF-IDENTIFIED TENNIS CANADA RATING (3.0 or Less): ___________

* ** 2014 SANCTIONED CANADA 55+ ASSOCIATION PLAYER:  Yes: ________ No: _______

DATE MAILED: _____________

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WAIVER OF LIABILITY FORM
 
(DON'T FORGET TO SIGN THIS FORM AT THE BOTTOM)

NAME OF TENNIS CLINIC PARTICIPANT: ______________________________________

          IN CONSIDERATION of my participation as a voluntary tennis clinic participant at the annual CCITC NATIONAL "LIVING HEALTHY" SENIOR TEAM TENNIS "DOUBLES" TOURNAMENT, CBRM, Cape Breton Island" (hereafter cited as "said CCITC Tennis Tournament"), and of my use of facilities associated with the tournament, I do hereby waive, release and forever discharge the CCITC, the Cape Breton Regional Municipality, and all respective officers, agents, employees, representatives, executors, and all others from any and all responsibilities or liability for injuries or damages resulting from my participation in any voluntary tennis clinic at the "said CCITC Tennis Tournament," or in any related activity, including but not limited to: practices, competitions, meetings, travel, and social events.
          I UNDERSTAND that my clinic participation at the "said CCITC Tennis Tournament," is strictly voluntary, and that I assume the risk for harm or injuries caused by such participation. I have been strongly advised that I should have sufficient insurance coverage.
          SINCE PARTICIPATION in Physical activity may involve increased risk or personal injury, I hereby acknowledge that participation in any voluntary tennis clinic at the "said CCITC Tennis Tournament," often involve exposure to risks of injury, minor to serious, including permanent disability a/o death. These type of injures may result from my own actions or inactions of others, or a combination of both. IT IS RECOMMENDED that I consult with a physician prior to participating in physical activity. I do hereby declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent or impair my participation in any voluntary tennis clinic activities at the "said CCITC Tennis Tournament," a/o facilities a/o equipment. I do acknowledge that I have been informed of the recommendation for a physician's approval prior to my voluntary tennis clinic participation at the "said CCITC Tennis Tournament." I acknowledge that I have either had a physical examination and have been given my physicians permission to participate, or that I have decided to participate without the approval of my physician and do assume all responsibility for my actions.
          MY SIGNATURE certifies that I understand and accept the conditions required for participation at the "said CCITC Tennis Tournament."

Signature: _____________________________________ Date: ____________________

MAIL TO: Eric Krause, Chair, CCITC, 62 Woodill Street, Sydney, Nova Scotia, B1P 4N9. (Please note: This is a free clinic - No charge)