Track & Field Athletic Association

Mississauga Olympians

Track & Field Athletic Association

#43-2079 The Collegeway Mississauga, Ontario L5L 3M1s 905-997-2713

Membership Benefits

·  Professional Coaching and Support
·  Entry Fees to competitions
·  Official Team Uniform / ·  Membership with Athletics Ontario
·  Annual Team Banquet

Team Membership Fee

$650.00 September-August or January-December

Contact Information

Minor Program / Jr. Development
Carla Warwick
/ Carla Warwick

Tasha Warwick-Fletcher
/ Tasha Warwick-Fletcher

Charmaine Warwick
/ Trevino Betty

Tricia Warwick
/ Ellis Perryman

Octavia Beckles
/ Collin Lewis

Karl Layne

Conditions of Registrations

·  Club fees are non-refundable or transferable.

·  Any other costs not outlined in this registration package will be the sole responsibility of the athlete or parent.

·  Club registration fees are not prorated regardless of athletes start date

·  It is advisable for the applicant to undergo a medical check-up prior to starting the program

Fundraising Agreement

·  Athletes or their designated substitute agree to participate in at least 3 fundraising initiative a year. You will be given notice in advance of the events at which time you will sign up for the events that accommodate your schedule best. If you fail to follow through on your commitment your child will become ineligible to partake in upcoming competitions and be subjected to a fundraising opted out fee of $50.00per event. This fee needs to be paid in order for your child to be reinstated for competitions.

Please sign below that you have read and understand the above conditions and agreement

Parents Name Signature Date

Athletes Name Signature Date

What MO expects from our parents

·  To support and encourage their child,

·  Help their child learn that success is experienced in the development of their skills and that they can feel good about themselves, win or lose,

·  To encourage and support healthy living through appropriate nutrition and rest,

·  To be a positive role model through your own actions to make sure your child has the best athletic experience possible,

·  Be a “team” fan, not a “my kid” fan,

·  Show respect for the opposing athletes, coaches, spectators and clubs,

·  Be respectful of all officials’ decisions,

·  Praise athletes in their attempt to improve themselves as athletes and as individuals,

·  Gain an understanding and appreciation for the rules of the sport,

·  Recognize and show appreciation for outstanding achievement by any athlete,

·  Take time to talk with coaches in an appropriate manner, including proper time and place, if there is a concern,

·  Be responsible for making your own arraignments for traveling to practices and competitions

·  To ensure and assist your to get to practice regularly and on time,

·  To repay any meet entry fees paid for events in which they are entered but do not participate

·  To inform coaches if your child will be attending a meet by the time requested by the coach and

·  Respect the Coaches decision when it comes to events your child will be participating in.

What MO expects from their athletes

·  Athletes are expected to do their best, play by the rules of the game, and accept losing and winning graciously,

·  Athletes are expected to display a positive and consistent work ethic,

·  Athletes are expected to treat others as they wish to be treated,

·  Athletes are expected to be attentive to their coaches and to follow coaching directives and suggestions,

·  Athletes are expected to refrain from the use of demeaning or belittling language,

·  Athletes are expected to arrive at practices and meets at the times designated by their coaches.

·  Athletes should be ready to go at least 15 minutes before practice,

·  Athletes are expected to arrive ready to compete and represent their team,

·  Athletes are expected to bring any concerns they may have to the attention of their coaches and their parents, knowing it will be dealt with in a confidential manner,

·  Athletes must do volunteer work for the club. A volunteer can be designated to fulfill volunteer requirements on behalf of the Athlete (i.e., parents, family members, etc.)

Jr. Development Program Cost $ 650.00 Payable by cash, cheque to "Mississauga Olympians Track Field Club"
Full Year January-December or September-August
¨Mississauga ¨North York

ATHLETE INFORMATION

Last name: / First: / Birth date: / Age: / Sex:
M / F
Street address: / City / Postal Code
Home Phone / Cell Phone : / Email
() / ()

PARENT/GUARDIAN INFORMATION

Parent Guardian last name: / First: / Mr.
Mrs. / Miss
Ms.
Address (if different):: / City / Postal Code
Home Phone / Cell Phone : / Email
() / ()

IN CASE OF EMERGENCY

Name of local friend or relative (not living at same address): / Relationship to Athlete: / Home phone : / Cell phone:
() / ()

Appointment of Attorney

I appoint a representative of the Mississauga Olympians Track and Field Athletic Association to be an Attorney in accordance with the Power of Attorney act and to do in my behalf anything that I can lawfully do as Attorney.

This Power of Attorney is subject to the following conditions and restrictions and shall only apply to enable the said Attorney to execute entry forms, waivers and other documents as required to permit (name of athlete), Age _____ (age of athlete) of whom I am the (either Mother, Father or Legal Guardian) to participate in any event sponsored or sanctioned by the Minor Track Association of Ontario, Athletics Ontario and any other athletics governing body during the year ______ending December 31st, inclusive.

Waiver, Consent and Authorization

In consideration of the Mississauga Olympians Track and Field Athletic Association accepting my child’s application as a participant in the above said program, I agree that my child will abide by the rules and regulations, policies and procedures of the Mississauga Olympians Track and Field Club in respect to the said program. I am aware of the possibility of health and safety risks associated with my child’s participation in the activities and I freely accept all risks associated with his/her participation. I assume all risks incidental to such participation, and do waive, release, absolve, indemnify and agree to hold harmless, other than for willful default or negligence on their part, the Mississauga Olympians Track and Field Athletic Association, its officers, directors, employees or agents.

Parent(s)/Guardian Name:

Signature: Date:

Office Use □ Payment Received Amount ______Cheq# _____ □ Cash □Other _____

Mississauga Olympians Track And Field Club

EMERGENCY RESPONSE FORM – CHILDREN & YOUTH

This form is confidential and must be viewed only by senior staff during emergency situations

Athletes First Name / Last Name / Date of Birth (DD.MM.YY)
Address / City / Postal Code
Father/Guardian Name / Telephone / Cell Phone
Mother/Guardian Name / Telephone / Cell Phone
Emergency Contact / Relationship / Telephone
Medical Conditions / Allergies
Medications
Special situations or information that may be relevant to the athletes health
Doctors Name Telephone
Last Physical Date

Consent to Seek Medical Attention

I will notify the Mississauga Olympians Track And Field Club of my child’s special medical condition or health history, if any. If the emergency contact person identified in this form cannot be reached and my child has an injury, accident or falls ill, I hereby authorize the Mississauga Olympians Track And Field Club to provide my child with or make arrangements for emergency medical treatment.

Parent Signature Date

Athletic History

Question / Answer
What grade are you currently in?
List any other sports you play and at what level (rep, school, recreation)
How long have you been running track?

Track History

Event / Personal Best Time/ Distance

Uniform Size

Men
Size / Women
Size
Shirt
Hoodie
Singlet
Bottoms

Note: Additional fees may be required to obtain specialized training from qualified coaches in the areas of Strength, Hurdles, Long Jump, High Jump and Throwing events. These fees will be paid directly to these individuals and organized through the Mississauga Olympians Track and Field Association.