Pre-Competitive Registration Form

Medical Release Form

The undersigned (Parent/Guardian(s)) hereby irrevocably appoint the Olympium Synchronized Swimming Club and its members and employees as my/our agent to authorize any necessary medical treatment for the participant from time to time throughout the period commencing September 1, 2018 and ending August 31, 2019 while the athlete is under the care and supervision of the club. The undersigned further releases the club and its members, volunteers, trustees, employees and agents from any liability for any damage or injury of any type cause to the athlete in connection with any dealings and associations with the Club including the authorization of necessary medical treatment as referred to herein. These dealing and association with the Club would include, but not be limited to, practice, competitions and trips, of which, may be outside the province or country.

Medical Release - Name of Participant

First Last

Name of Parent/Guardian*

First Last

Parent/Guardian Email*

You will receive a PDF of this form at this address

Signature of Parent/Guardian*

Date*

Participant’s Agreement for MINOR CHILD

To be signed by the parent/guardian of a minor participant

synchroontario

Club: OLYMPIUM SYNCHRONIZED SWIMMING CLUB

ALL SPORTS, INCLUDING SYNCHRONIZED SWIMMING, HAS ITS RISKS

I participate in the sport of synchronized swimming because it is physically and mentally challenging. In consideration of my participation in such programs, activities and events, I hereby acknowledge that I am aware of the risks and hazards associated with or related to synchronized swimming. The risks and hazards of synchronized swimming include, but are not limited to: • Injuries from executing strenuous and demanding physical techniques in synchronized 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 cardiovascular 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 synchronized swimming can be severe; • That I may come into close contact with other participants, including the possibility of accidental and unexpected touching; • That I may experience anxiety while challenging myself during the activities; • That my risk of injury is reduced if I follow all rules adopted during training; and • That my risk of injury increases as I become fatigued.

I AGREE TO BE RESPONSIBLE FOR MYSELF

I am participating voluntarily in these activities, events and programs. I agree that there are risks in synchronized 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: Synchro Swim Ontario, its directors, officers, members, employees, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of the facility, and representatives.

I ACKNOWLEDGE MAKING THIS AGREEMENT

I have read and understood the terms and conditions of this agreement, and by signing it voluntarily, I am agreeing to abide by these terms.

Minor Child - Name of Participant*

First Last

Name of Parent/Guardian*

First Last

Signature of Parent/Guardian*

Date*

CONSENT FOR EMERGENCY MEDICAL TREATMENT

To be signed by the parent/guardian of a minor participant

synchroontario

I, Parent/Guardian (below) of Participant (below), give permission to the officials and coaches of Synchro Swim Ontario 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 Synchro Swim Ontario will make every reasonable effort, in the circumstances, to contact me regarding my child’s/ward’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. By signing here, 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 officials and coaches of Synchro Swim Ontario.

Emergency Medical - Name of Participant*

First Last

Name of Parent/Guardian*

First Last

Signature of Parent/Guardian*

Date*

PHOTOGRAPH AND INFORMATION PERMISSION

Synchro Swim Ontario requests that each club has their members sign a permission form to allow the use of photos/videos to be used for a variety of purposes and that the form includes permission for Synchro Swim Ontario to also use such materials. For more information on how Synchro Swim Ontario uses photos/videos, refer to the Privacy Policy at www.synchroontario.com.

The undersigned authorizes Olympium Synchronized Swimming Club and Synchro Swim Ontario to permit photographers/videographers employed or designated by Olympium Synchronized Swimming Club and Synchro Swim Ontario 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, 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 Olympium Synchronized Swimming Club or Synchro Swim Ontario.

Photo Consent - Name of Participant*

First Last

Name of Parent/Guardian*

First Last

Signature of Parent/Guardian*

Date*

AGREEMENT TO RECEIVE ELECTRONIC COMMUNICATIONS

Synchro Swim Ontario requests that each club has their members sign a permission form to permit electronic communication with swimmers and/or their parent(s)/guardian(s). For more information on how Synchro Swim Ontario uses electronic communications, refer to the Privacy Policy at www.synchroontario.com.

I, the participant and/or parent/guardian, agree to receive electronic communications from Synchro Swim Ontario and member clubs including the Olympium Synchronized Swimming Club. 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 Synchro Swim Ontario or Olympium Synchronized Swimming Club, I can withdraw my consent at any time using the process set out in the Synchro Swim Ontario or Olympium Synchronized Swimming Club Privacy Policy.

Electronic Communications - Name of Participant*

First Last

Name of Parent/Guardian*

First Last

Signature of Parent/Guardian*

REGISTRATION FEE PAYMENT

Total: Early Registration Fee

$ 0.00 CAD

Payment Method*

Credit Card (via PayPal)

Clicking SUBMIT will re-direct you to PayPal – it may take a minute before the screen updates

OSSC 2018-19 Pre-Competitive Registration Information Form

Step 1 of 2

Athlete's Details

Parent / Guardian 1

Parent / Guardian 2

Emergency Contact

Medical Release Form

Participant’s Agreement for MINOR CHILD

ALL SPORTS, INCLUDING SYNCHRONIZED SWIMMING, HAS ITS RISKS

I AGREE TO BE RESPONSIBLE FOR MYSELF

I ACKNOWLEDGE MAKING THIS AGREEMENT

CONSENT FOR EMERGENCY MEDICAL TREATMENT

PHOTOGRAPH AND INFORMATION PERMISSION

AGREEMENT TO RECEIVE ELECTRONIC COMMUNICATIONS

REGISTRATION FEE PAYMENT