Pre-Registration Form for TeamNWT at the
Canadian Francophone Games 2017 in Moncton-Dieppe
This form must be completed in order to be part of the NWT delegation at the Canadian Francophone
Games, in July 2017 (9 to 16). The following information will be used for the selection of players and for all
preparatory activities for the Games. This form also constitutes the participant's contract of engagement.
This is not the official registration at the Games. The official registration will be in April, once we have all
the documents.
Instructions :



Read the document carefully
Indicate clearly your personal informations.
Read your emails regularly! We will send you important informations.
A $ 100 deposit on the registration fees is required. The deposit will be used to pay for uniforms,
training gear etc. This also serves to guarantee the place of the participant in the team. Payment can be
made:
-
Cash : In person at the Blue House (5016, 48e rue) or directly at the Youth Coordinator (Alexandre
Assabgui) during an event. A receipt will be issued.
By check : at the name LA FÉDÉRATION FRANCO-TÉNOISE and can be sent to :
o P.O box 1325, Yellowknife (NT), X1A 2N9, Canada
o In person at the Blue House (5016, 48e rue) or directly at the Youth Coordinator (Alexandre
Assabgui) during an event. A receipt will be issued.
During the months before the Games, you must participate in at least 2 fundraising activities. Amounts
raised will reduce the registration fees and cover other TeamTNO expenses
PERSONAL INFORMATION
First name :
Gender :
#:
City :
Home Phone :
E-mail :
Last name :
F
M
Street :
Territory :
(
)
Date of birth :
NWT
Mobile :
____/____/_______
(dd/ mm / yyyy)
Ap :
Postal code :
(
)
Clothing size (in
general):
Allergies
XS
S
M
L
XL
XXL
XXXL
I’m allergic to : _________________________________________________________________
Please specify the allergic reaction : ______________________________________________________
-
I can have an allergic reaction if I eat the allergen.
Yes
No
-
I can have an allergic reaction if I am in contact with allergen (smell, touch).
Yes
No
-
This allergy is serious and possibly fatal (anaphylactic shock).
Yes
No
-
I carry an Epipen in case of emergency.
Yes
No
DISCIPLIN
Choose 1 to 3 disciplines and indicate your preference. The first choice is not guaranteed.
Arts :
Leadership :
___Visual Arts
___Music
___ Improvisation
___ Theater
___ Oral presentation
___ Leadership in action
___Media
Sport :
Badminton(Please specify) :
Basketball
___ Single
Volleyball
___ Double
Ultimate Frisbee
Soccer
Track and Field (Please choose 2-4 competitions, Relay race counts separately):
Races: ___100m ___ 200m
___300m
___ 800m ___ 1200m ___2000 m ___Relay
Jumps :
___ Hight ___ Length ___ Triple jump
Throws : ___ Weight ___ Disc ___ Javelin
Comments/Special requests
Selection
To be a participant in the Games, a candidate must :
-
Be aged between 13 and 18 and born between January 1, 1999 and December 31, 2003
Be registered in one of the francophone schools, French immersion program or be a young
francophone registered in an NWT high school.
Have an acceptable knowledge of the French language (can be evaluate if necessary)
Code of conduct
The participant must follow the Regulation for Jeunesse TNO’s Activities during all the pre-Games
activities:
-
The possession and use of drugs and alcohol are strictly prohibited. In addition, the legal
regulations relating to the possession or consumption of drugs / alcohol apply.
Participants must be respectful to each other and to the authorities, they must demonstrate
good sportsmanship.
Vandalism, breakage, theft and aggression are strictly prohibited.
Possession of an unauthorized weapon is prohibited.
Commitment
The participant agrees to:
-
-
Speak French during all activities.
Pay the $ 100 deposit requested by JTNO before December 22, 2016 to secure its place.
Participate in at least 2 fundraising activities.
Respect Jeunesse TNO’s Code of Conduct.
Read the documents that will be handed in preparation for the Games.
Assume all risks of bodily injury and property damage, including theft, loss and deterioration of
property, and physical injury. In addition, the entrant releases the French-Canadian Youth
Federation (FJCF) and the Fédération Franco-Ténoise (FFT) from all liability and / or prosecution.
Pay the total registration fees in the amount of $ XXX (will be determinate in April and not
exceed 400$) before May 15, 2017.
If the participant withdraws after April 28, 2017 the expenses incurred for the Games are not
refundable. The $ 100 deposit is not refundable at all times (Except for certain cases determined
by the Youth Coordinator).
I consent to the use of all images (photo / video) taken during Games-related activities for promotional
purposes and for distribution by Jeunesse TNO.
PARENTS/GUARDIAN
The parents / guardian will be automatically cc for all important informations (accommodation,
transportation, payment)
First name :
Home phone
Last name :
(
)
Mobile
(
)
E-mail
I wish to receive in cc all communications sent to my child
Yes
No
The participant and his/her parent/guardian declare that they have read, understood and agree to the
terms and conditions set forth herein and undertake to abide by them at all times.
_______________________________
Signature of participant
________________________________
Date
_______________________________
Signature of parent
________________________________
Date
* Return the form to [email protected] , or [email protected] or in
person at Maison Bleue (5016, 48th Street) or by fax at 867-873-2158. As soon as possible.
For all questions/comments/inquiries
- By E-mail : [email protected] or [email protected]
- By Phone : (867) 920-2919 poste 258
- By Text message (only) : (639) 739-5314
- By Facebook : JeunesseTNO
- By Snapchat : Jeunessetno
- In person at the Blue House : 5016, 48e street, Yellowknife