ATHLETEREGISTRATION FORM

*PROVINCIAL ALL-AROUND (AA), PROVINCIAL EVENT SPECIFIC (ES) & NATIONAL*

Club :
Head Coach: / Club Contact (if different from Head Coach):
Telephone: / Main Email:
Email 2: / Email 3:

Note: It is VERYimportant to list ALL e-mail addresses you wish information such as Call to Meets, Athlete Draws, and Schedules to becommunicated.

There are FOUR parts to this registration form (A, B, C & D):

Part A: Provincial All-Around (AA) Athlete Registration / EVENT SETTINGS (optional):
FIRST NAME / LAST NAME / GYM CLUB / DISCIPLINE / 2013-2014Level / DATE OF BIRTH (dd/mm/yyyy) / Vault Height / Bars Setting/ Height / Beam Height
Women
Women
Women
Women
Women
Women
Women
Women
Women
Women
Women
Women
Women

Part B: Provincial EVENT SPECIFIC (ES) Athlete Registration

Please indicate you if have any “event specific” athlete registrations. These athletes can participate on 1 and/or 2 events only. Please indicate their events in the spaces provided (“event #1” and/or “event #2”).

**This option is only available to athletes in OCP Levels 7-9 who are 14 years of age or over (as of December 31st)**

FIRST NAME / LAST NAME / GYM CLUB / DISCIPLINE / 2013-2014Level / DATE OF BIRTH (dd/mm/yyyy) / Event #1 and Settings / Event #2 and Settings
Women
Women
Women
Women
Women
Women
Women
Women
Women

Part C: NATIONAL Athlete Registration

Register your National level athletes participating in Burlington (Elite Canada Screening) and/or Oshawa Qualifier (National Competition Opportunity)

FIRST NAME / LAST NAME / GYM CLUB / DISCIPLINE / 2013-2014LEVEL / DATE OF BIRTH (dd/mm/yyyy) / Qualifier Attending (Burlington/Oshawa or Both )
Women
Women
Women
Women
Women
Women
Women

Part D: COACH Registration

Please provide coach’s information for ALL coaches that will be attending Provincial Qualifiers. This information will be used for information such as numbers for hosting.

Accreditation: Coaches must be fully NCCP Certified Level 2 in Women’s Artistic Gymnastics and must have completed their Risk Management (Part A) and have current Respect in Sport (Part B). It is the responsibility of the Coach to ensure all certification is up to date and they are in possession of a Coach ID. All coaches must have an accreditation (Coach ID) and show it at all qualifying competitions to gain floor access.

In case of a lost, stolen or forgotten ID, coaches will be required to sign form number CP001 stating a minimum level 2 certification for verification. The host club registration desk will have this form available. For replacement Ids contact EducationCoordinator to discuss options of acquiring a replacement ID or an exemption.

It is the responsibility of the Club to notify the Women’s Program Manager if they have a coach that needs to be added during the season and/or if a coach has not received their Coach ID please contact the Education Coordinator, Yuliana Korolyova at ,aminimum of three weeks prior to the Qualifier to receive accreditation.

***2013-2014 Gymnastics Ontario membership registration deadline is October 15th 2013 ***

FIRST NAME / LAST NAME / GYM CLUB / DISCIPLINE / NCCP #
Women
Women
Women
Women
Women
CLUB ENTRY FEE INFORMATION (Payable to Host Clubs)
Athlete Type / # of Athletes / Fee Per Athlete / Total
Part A: Provincial (All Around) / X $80.00 / $
Part B: Provincial (Event Specific) / X $80.00 / $
ATHLETE TYPE / # OF ATHLETES / # OF QUALIFIERS / $100.00 PER ATHLETE/ PER QUALIFIER / TOTAL
Part C: National (CPN) / X 80.00 / $
National (JR, SR, NN, NO) / X $100.00 / S
LATE FEE (PER ATHLETE) / TOTAL
NSF FEE ($90.00)
GRAND TOTAL DUE: / $
PAYMENT INFORMATION:
Cheque #:

Registrations must be sent electronically directly to Women’s Program Manager and all three of your assigned host clubs.

Payment, in full, must be sent directly to all three of your host clubs. Payment must be by club cheque only, (no personal cheques will be accepted). Cheques should be payable to all three host clubs.

Registrations will not be considered complete without payment.

Registrations and payment received after the October 15th deadline will be subject to a $25.00 late fee per athlete per qualifier.

Any NSF or returned chequesmust be re-paid by cash, certified cheque or bank draft immediately, in person. In addition, there will be a non-negotiable service & handling charge of $90.00.

Full refund will only be granted if an athlete has not competed at any of the three Qualifiers. Refund requests must be submitted to the Women’s Program Manager no later than 2 weeks after the last Qualifier of the Season.

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