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HomeMy WebLinkAboutSportball Registration Form.pdf REGISTRATION FORM Program Type: ___________________ Location: _______________________ Day: __________________________ Time: _________________________ Start & End Date: ________________ (PLEASE PRINT) CHILD’S NAME: _______________________________________ D.O.B. (MM/DD/YY): ________________ GENDER: _____ SCHOOL CURRENTLY ATTENDING: ___________________________________________ HOME ADDRESS: ____________________________________________ CITY: _____________________ POSTAL CODE: _____________________ HOME TELEPHONE: __________________________________ E-MAIL ADDRESS: ____________________________________________________________________ PARENT’S NAME: ___________________________ PARENT’S NAME: ____________________________ BUSINESS NO: _____________________________ BUSINESS NO: ______________________________ CELL NO: __________________________________ CELL NO: ___________________________________ EMERGENCY CONTACT NAME __________________________________Tel #_______________________ CONTACT’S RELATIONSHIP TO CHILD: ___________________________________ Does your child have any special needs that our Coaches should be aware of e.g. (food allergies, hearing impaired, low muscle tone, attentional deficits etc)? _____________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ For the safety of all children with allergies, we require that no nut products are brought to any of our Sportball locations. I acknowledge that I have read and accept the Sportball Policies. I agree that Sportball can collect, use, disclose and store personal information as set out in their Privacy Policy. I hereby release Sportball and their coaches, employees from all claims, demands, losses, actions, suits or proceedings rising out of the participation of the applicant named in any facility or at any location where a program is being held. I also agree to consent to the use by Sportball of the Participant’s likeness (photographs, video) for publicity purposes. SIGNATURE: ______________________________________________ DATE: ___________________ PRINT NAME (LEGAL GUARDIAN): ______________________________ REFERRED TO SPORTBALL BY: _________________________________ Community Centre Policies and Procedures apply.Community Centre Policies and Procedures apply.Community Centre Policies and Procedures apply.Community Centre Policies and Procedures apply. 3289 HAPPY VALLEY ROAD, LANGFORD, BC, V9C 2W3 TEL: 1877-590–GOAL (4625) FAX: 250-590-5695 Website: www.sportball.ca E-MAIL: van.island@sportball.ca SPORTBALL POLICIES & REGISTRATION VISIT OUR WEBSITE @ www.sportball.ca PRIVACY POLICY: • We collect information about your family to provide the best and most appropriate care for your child. • All family personal information is processed and stored in a secure database with access controls. • We use this information for statistical analysis to develop programs required for the future. • We do not sell or rent your family information to any person or organization. Information is only given to those directly involved in providing a service to your child, or as required by law. Forms are destroyed at the end of each season. • We retain your information to enable us to communicate with you if we have new information that may be of interest to you. ARRIVAL & DISMISSAL POLICY: • Parents/Caregivers must sign children in & out of programs (Sign out only for after school programs). No child can be left unattended before class! • If your child is to be picked up by someone other than yourself, please provide a note to your child’s coach. Children will not be released to anyone unknown to the Sportball Coach. TRANSFER POLICY: • Transfers may be accommodated within the same season registered, subject to approval. Transfers cannot be made between Indoor programs and Outdoor Soccer programs or Camps. MAKE-UP CLASSES & CANCELLATIONS: • Make-up classes will not be offered as a result of RAIN, SNOW OR EXTREME HEAT if Sportball cancels the class. • Sportball reserves the right to cancel any program due to insufficient enrollment. Upon cancellation, a full refund will be made. OUTDOOR PROGRAMS: SOCCER, BASEBALL & MULTI-SPORT: • Parents are required to remain with their children at the field or park at all times. If you have more than 1 child registered at the same time in a different group, each child must be supervised by an adult. • Please provide your child with a drink in a non-breakable container, as there will be a short drink break. FALL, WINTER & SPRING 1 HOUR DROP OFF PROGRAMS/AFTER SCHOOL PROGRAMS: • Please do not bring snacks to the class. • Please provide your child with a drink in a non-breakable container, as there will be a short drink break. • Children should wear non-marking shoes and gym clothes. No street shoes or boots will be allowed in the gym area. • We encourage parents to attend our Parent Participation week held once each season. Cameras are permitted. Video cameras are not allowed in the gymnasium. PARENT & TOT AND ME & MY DAD: • Please do not bring snacks to the class. • NEWBORNS AND TODDLERS NOT REGISTERED IN CLASSES CANNOT ACCOMPANY PARENTS & SIBLINGS IN THE GYM. • This is a Parent Participation program. Only one parent per child is permitted into the gym. • Cellular phones are not permitted in the gym. HOLIDAY SEASON CAMP, MARCH BREAK CAMP & CLINICS: • Each child must bring a small nut free snack as well as a drink in a non-breakable container for snack time. 3289 HAPPY VALLEY ROAD, LANGFORD, BC, V9C 2W3 TEL: 1877-590–GOAL (4625) FAX: 250-590-5695 Website: www.sportball.ca E-MAIL: van.island@sportball.ca