Academy Short Track Registration
Skater Name *
Your answer
Email Address *
All future communications regarding Academy ST will be sent to this email address.
Your answer
BCSSA Club *
Your answer
Age as of July 1st, 2018 *
Your answer
Camps *
Please select all Academy ST Camps you will be attending.
Required
Waiver
The skater's legal guardian should complete the Medical Clearance Confirmation and Waiver if the skater is under 19. The name entered should be that of the legal guardian, where applicable.
Medical Clearance Confirmation *
All physical activity has inherent risks. To the best of my knowledge, I am medically fit to participate in Academy ST.
Required
Please list any medical conditions the coaches and organizers should be aware of. *
Your answer
BC Care Card (Personal Health Number) *
Your answer
Waiver *
By signing this entry form, I hereby, for myself, my heirs, executors, administrators and assigns, waive and release any and all rights and claims for damages I may have against the BCSSA and all sponsors/supporters concerned, their agents, Officers or members, for any and all injuries suffered by me at said Academy ST to be held September 2018- February 2019 in British Columbia, Canada.This information is collected under the authority of the Freedom of Information and Protection of Privacy Act. It is required to register you in the Academy. Organization of events requires that names may appear on posted lists and printouts. Names/images of participants may be published on boards, websites, media, newsletters and promotional material. Alternative contact and medical information will only be used in a medical emergency. If you have questions about the collection of or use of this information, contact the Event Organizer at 250.300.9908 or by email at chris.acton@speed-skating.bc..ca.
Required
Type your full name to confirm agreement *
Your answer
Payment
*
All payment for Academy ST will be processed via PayPal. The cost for the Academy ST Series is $95 per camp.
Required
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