COACH CONTACT INFORMATION |
||||||||||||||||||
|
Full Name: |
|
|
|
|||||||||||||||
|
Last |
First |
M.I. |
||||||||||||||||
|
Address: |
|
|
||||||||||||||||
|
Street Address |
Apartment/Unit # |
|||||||||||||||||
|
|
|
|
|
|||||||||||||||
|
City |
Province |
Postal Code |
||||||||||||||||
|
Home Phone: |
( ) |
Business Phone: |
( ) |
|||||||||||||||
|
Cell Number: |
( ) |
E-mail Address: |
|
|||||||||||||||
|
|
||||||||||||||||||
|
COACH INFORMATION |
||||||||||||||||||
|
Birth Date: (y/m/d) |
|
OSA Registrant # |
|
Gender: |
|
|||||||||||||
|
|
|
|||||||||||||||||
|
TEAM DETAILS |
||||||||||||||||||
|
Club Name: |
|
Team Name: |
|
|||||||||||||||
|
|
||||||||||||||||||
|
League Name: |
|
Division Name: |
|
|||||||||||||||
|
|
||||||||||||||||||
|
Indoor: __ Mini Indoor ___ Youth Indoor ___ Senior Indoor ___ Pro Indoor __ Mini Futsal ___ Youth Futsal ___ Senior Futsal ___ Pro Futsal |
||||||||||||||||||
|
|
||||||||||||||||||
|
Outdoor: ___ Mini Outdoor ___ Youth Competitive ___ Youth Recreational ___ Senior Competitive ___ Senior Competitive ___ Pro Outdoor |
||||||||||||||||||
|
|
||||||||||||||||||
|
|
|
|||||||||||||||||
|
CONSENT FOR USE OF PERSONAL INFORMATION |
|
|||||||||||||||||
|
I authorize the Canadian Soccer Association, Ontario Soccer Association, ECOSA and PYSC to collect and use personal information about my child/ward for the purpose of receiving communications from the Canadian Soccer Association, Ontario Soccer Association, District Association, League and Club.
I understand that I may withdraw such consent related to receiving communications at any time by contacting the OSA Privacy Officer at OSAPrivacyOfficer@soccer.on.ca or by mail to: Attention: OSA Privacy Officer, Ontario Soccer Association, 7601 Martin Grove Road, Vaughan ON L4L 9E4. The Privacy Officer will advise the implications of such withdrawal. *We do not sell or distribute your personal information to any other third party not listed herein.* |
|
|||||||||||||||||
|
ACCEPTANCE OF TERMS AND CONDITIONS |
|
|||||||||||||||||
|
In consideration of the acceptance of my child/ward’s membership in the Canadian Soccer Association, Ontario Soccer Association, District Association and Club, I, the parent/guardian (for the participant under 18 years of age) agree as follows:
1. I understand that my child/ward cannot coach in any sanctioned soccer game until after this registration form has been validated and the registration data has been entered in The Ontario Soccer Association's computerized registration system. 2. I have reviewed the Participant’s agreement attached (page 2) and my signature affixed hereto indicates my agreement with such Participant’s Agreement 3. I am aware of The Ontario Soccer Association, ECOSA, PYSC and League bylaws, policies, rules and regulations and agree to abide by them and to be bound by them. 4. I accept sole responsibility for my child/ward’s possessions and athletic equipment. 5. I accept all liability for any damage to the coaching or field equipment caused by my child/ward or my child/ward’s careless, negligent and/or improper handling.
By signing and dating below, you agree that you are the parent or legal guardian of the coach being registered and to be bound by this Legal Agreement even if you have not read the agreement.
______________________________________________ _____________________ Signature of Parent/Guardian Date |
|
|||||||||||||||||
|
For use by CLUB REGISTRAR
SIGNATURE___________________________
Date ____________________ |
For use by District Association
SIGNATURE___________________________
Date ____________________ |
|
||||||||||||||||
Note: An organization must retain copy of the Coach registration form and if requested must submit form to its District Association or the Ontario Soccer Association upon request
Revised February, 2011
ONTARIO SOCCER ASSOCIATION
PARTICIPATION AGREEMENT
FOR THOSE UNDER 18 YRS
By signing this document you will waive certain legal rights, PLEASE READ CAREFULLY.
Name of Participant: _______________________________________________ Date of Birth ______________
IN CONSIDERATION of allowing my minor child/ward to participate in the programs, activities and events of The Ontario Soccer Association, I ASSURE TO YOU THAT:
1. I am the parent/guardian of the above named participant having full legal responsibility for decisions regarding the above named participant.
2. I believe that my child/ward is physically, emotionally and mentally able to participate in the programs, activities and events of The Ontario Soccer Association.
3. I hereby acknowledge that I am aware of the risks and hazards associated with or related to soccer. The risks and hazards include, but are not limited to injuries from:
a. Executing strenuous and demanding physical techniques in soccer;
b. Dryland training including weights, running and massage;
c. Grass, turf and other surfaces including bacterial infections and rashes;
d. Falls to the ground due to uneven or irregular terrain or surfaces;
e. Collisions with walls and soccer equipment;
f. Failure to properly use any piece of equipment or from the mechanical failure of any piece of equipment;
g. Extreme weather conditions which may result in heatstroke, sunstroke or hypothermia;
h. Contact, colliding or being struck by other participants, spectators, equipment or vehicles;
i. Vigorous physical exertion and strenuous cardiovascular workouts;
j. Exerting and stretching various muscle groups; and
k. Travel to and from competitive events and associated non-competitive events which are an integral part of the organization’s activities.
4. Furthermore, I am aware that my child/ward may:
a. Sustain injuries in soccer that can be severe, cause spinal cord injuries and even be fatal;
b. Experience anxiety while challenging himself/herself during the activities, events and programs;
c. Come into close contact with other participants, including the possibility of accidental and unexpected contact;
d. Risk of injury is reduced if he/she follows all rules established for participation; and
e. Risk of injury increases as he/she become fatigued.
I UNDERSTAND AND AGREE, on behalf of myself, my heirs, assigns, personal representatives and next of kin that my signing of this document constitutes:
5. I am registering my child/ward willingly and my child/ward is participating voluntarily in these activities, events and programs.
6. I agree that there are risks in soccer as described above and my child/ward will be exposed to these risks and hazards.
7. I agree to accept all these risks and hazards and be responsible for any injury or other loss which my minor child/ward might receive while participating in these events, activities and programs.
8. If something happens to my child/ward, I release the Organizers of responsibility for any claims, demands, actions and costs which might arise out of my child/ward’s participation. I understand “Organizers” to mean: The Ontario Soccer Association, District Associations, Leagues, Clubs and their directors, officers, members, employees, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of facilities, and representatives.
Accident Insurance
Executing this agreement will not preclude your child/ward from accident insurance coverage, subject to the terms and conditions of The Ontario Soccer Association’s insurance policy.
I ACKNOWLEDGE MAKING THIS AGREEMENT
By signing and dating below, you agree that you are the parent or legal guardian of the coach being registered and to be bound by this Legal Agreement even if you have not read the agreement
_________________________________ _________________________ __________________
Printed Name of Parent or Guardian Signature of Parent or Guardian Date
Revised February, 2011