SGCC Junior Curling Registration

Our JUNIOR curling program is for individuals between the ages of 13 and 20 (must be less than 21 years of age as of June 30, 2024). This group includes both novice and experienced curlers.

This form must be completed no later than October 18, 2024.

Personal Information

First Name *

Last Name *

Address *

City/Town *

Province *

Postal Code *

Email Address *

Date of Birth *

Gender *

School *

Curling Experience *

None	# of Years # of Years

Health Card Number

Family Doctor

Family Doctor Telephone

Allergies

Parental/Guardian/Emergency Contact Information

Parent

Telephone

Parent

Telephone

Other

Telephone

Payment Information

Cost: *

Total Owing:

0.00

***CANNOT ACCEPT VISA DEBIT or DEBIT MASTERCARD***

Credit Card Type

Name on Card

Credit Card Number

Expiration Date (mm/yy)

CVC

or, bill to Member Account:

Form Submission

Required Waivers *

By checking this box, you are confirming that all applicable waivers found below have been electronically signed and submitted before being able to participate.

CURLING MEMBERS 18 - 26

Waiver/Acknowledgement of Risk for Adults

Rowan's Law Concussion Awareness Code of Conduct

Rowan's Law Acknowledgement of Receipt

CURLING MEMBERS UNDER 18

Waiver/Acknowledgement of Risk for Minors

Rowan's Law Concussion Awareness Code of Conduct

Rowan's Law Acknowledgement of Receipt

Player Agreement:

I agree to abide by all rules and regulations as laid out by the Sarnia Golf & Curling Club (“the Club”) and by its Affiliates. I further agree to obey those in charge of my team, to respect all officials, to refrain from using profanity, to respect all Sarnia Golf & Curling Club property, and to conduct myself as an Athlete and a Gentleman/Lady at all times. I agree to accept the responsibilities of being a good Club member.

Date of Submission * +

Player Signature *

clear

Parent/Guardian Agreement:

When your son or daughter is placed on a team each week, the other players will expect him or her to live up to his or her responsibilities as a good team member. If you feel that he or she can meet these requirements, please fill out the following:

I hereby declare that I am willing to allow my son or daughter to curl and will not hold the Sarnia Golf & Curling Club Limited, its agents, executive, volunteers, employees, or sponsors, responsible for injuries incurred by my son or daughter as a member of the Sarnia Golf & Curling Club Limited.

Note: Please inform coaches of any health concerns.

Date of Submission +

Parent/Guardian Signature

clear