Contact Information First name: Middle name: Last name: Gender: Address: Postal code: Mobile phone: Home phone: Work phone: Member since: Years curling experience: Email: BC Care Card (youth members): Emerg. contact: Emerg. phone: Date of birth: Electoral area: City E F Other: Consent to Release Information, Privacy Policy and Anti‐Spam Policy Adult Members: I hereby consent to the use of the personal information provided above by the Nelson Curling Club administration. Only my name, email address and phone numbers will be listed in the membership directory and/or private member website for general member use. This information is intended for the sole use of the Nelson Curling Club and will not be shared with other individuals or organizations. Parents/Guardians of Youth Members: On behalf of my child/ward, I hereby consent to the use of the personal information provided above by the Nelson Curling Club administration. Only my child/ward's name, email address and phone numbers will be listed in the membership directory and/or private member website for general member use. This information is intended for the sole use of the Nelson Curling Club and will not be shared with other individuals or organizations. Injury Waiver Adult Members: In consideration of acceptance of this registration by the Nelson Curling Club ("the club"), I HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE the club and each of its members, officers and employees FROM ANY AND ALL claims, demands, damages, costs, expenses, actions and cause of action, whether in law or equity in respect of death, injury, loss or damage to myself or property, arising or to arise by reason of my participation in the club, that has not been contributed to or occasioned by any negligent act, by omission or commission, of any of the aforesaid. Parents/Guardians of Youth Members: I understand that there is a degree of risk involved with this activity. After considering all the risks involved, and having confidence that all reasonable safety precautions will be taken for the safety and well‐being of my child/ward, I hereby give my child/ward permission to participate in Youth Curling programs at the Nelson Curling Club. I also grant authority to the Nelson Curling Club coaches and/or club representative to take or authorize any action intended to assist my child/ward in an emergency situation. In consideration of acceptance of this registration by the Nelson Curling Club ("the club"), I HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE the club and each of its members, officers and employees FROM ANY AND ALL claims, demands, damages, costs, expenses, actions and cause of action, whether in law or equity in respect of death, injury, loss or damage to my child/ward or his/her property, arising or to arise by reason of his/her participation in the club, that has not been contributed to or occasioned by any negligent act, by omission or commission, of any of the aforesaid. Regular Membership ½ League1 1 League 2 Leagues 3 Leagues 4 Leagues Select Leagues Daytime Open Tuesday Men’s Wednesday Ladies’ Thursday Men’s Friday Mixed Total membership fee: $ _________ $170.00 $315.00 $490.00 $665.00 $840.00 ($195.00 after Oct. 31) ($340.00 after Oct. 31) ($515.00 after Oct. 31) ($690.00 after Oct. 31) ($865.00 after Oct. 31) Team/Skip: Team/Skip: Team/Skip: Team/Skip: Spare or Monday Drop‐in Membership Pay‐as‐you go $20.00 (plus $10 per visit) Unlimited $130.00 Select Time Monday Youth Drop‐in Monday Evening Drop‐in Spares List Specify league(s): Youth Membership Juniors Little Rockers Nov ‐ Dec Non‐Curling Memberships Associate Non‐voting Associate $100.00 $30.00 $25.00 $10.00 Additional Fees Total additional fees: $ _________ Locker rental $25.00 Locker #: New curler package $140.00 (shoes and broom) Discounts Total discounts: $ _________ 2
Friday‐only discount $60.00 Student discount3 60% off regular membership fee Total registration fee (membership + additional fees – discounts) $ _________ In which capacity would you prefer to volunteer? Coaching Admin/Committee Bartending What is the best way to contact you to volunteer? Email Phone Other We are a volunteer‐run organization. By volunteering at least once a season, you help make all our events very successful. Thank you in advance. Notes: 1. If you will only play roughly half the scheduled games in a league (e.g., due to vacation, sharing a position on a team, etc.), you are eligible for a reduced rate in that league. If your half‐season league is the ONLY league you will play in, select the 1/2 league membership. If you want to play a full season in one or more league PLUS a half season in another league, please round up the number of leagues to the next whole number and select the corresponding multi‐league membership rate, e.g., to play a full season in Tuesday Men and a half season in Friday Mixed (1‐1/2 leagues), select a 2‐league membership. The multi‐league rates include a discount of approximately 50% off the regular league rate for additional leagues. 2. Friday‐only discount applies to 1‐league membership in the Friday Mixed league ONLY. Cannot be applied to multiple‐league memberships or combined with student discount. 3. Student discount applies if you are a full‐time secondary or post‐secondary student curling in one or more adult leagues. Cannot be combined with any other discount. Applies only to regular membership fee.