2013 Player Registration and Waiver Forms

CCITC NATIONAL "LIVING HEALTHY" SENIOR TEAM TENNIS "DOUBLES" TOURNAMENT
ccitc@cromartytennis.ca [Defunct]

PLAYER REGISTRATION AND WAIVER FORMS

(PLEASE PRINT ALL INFORMATION)

Only registered club members are eligible for this tournament

THE NAME OF YOUR TEAM CAPTAIN: _______________________

PROVINCIAL CLUB NAME: __________________________________________

CLUB LOCATION: ___________________________________________________

YOUR LAST NAME: __________________________________________________

YOUR FIRST NAME: ___________________ INITIAL: _____________________

YOUR MAILING ADDRESS: __________________________________________

CITY/TOWN: __________________ PROVINCE/TERRITORY: ______________

POSTAL CODE:_______________________________________________________

HOME PHONE: ___________________ CELL PHONE: ____________________

YOUR E-MAIL: _______________________________________________________

PLAYER'S AGE AS OF NOVEMBER 19, 2014: _______ GENDER: M: ____ F: ____

SELF-IDENTIFIED TENNIS CANADA RATING (3.5 or Greater): _____________

WISH TO COMPETE IN WHICH
GENDER GROUP (Check One Only): Men's: __ Women's: __ Mixed: ___

CHEQUE AMOUNT (See Fee Schedule): ___________ DATE MAILED: _________

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

* MAKE CHEQUE OUT TO:

CROMARTY COMMUNITY INDOOR TENNIS CENTRE *

          IN CONSIDERATION of my participation as a tennis player or volunteer 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, in addition to the payment of my registration fee, 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 tennis match in 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 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 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 activities of 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 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."

MAIL TO: Eric Krause, Chair, CCITC, 62 Woodill Street, Sydney, Nova Scotia, B1P 4N9. (Please note: All registration fees are not-refundable if your team is accepted for the tournament).