The Coast Club Registration Form

Child information

Child's name *

Age *

Birthdate * +

Does the child have any allergies? If so, please explain.

Parent/Guardian 1 name: *

Parent/Guardian 2 name: *

Address *

City *

Province *

Zip code *

Parent Email *

Parent 1 Phone number *

Parent 2 Phone number *

Emergency contacts

Emergency contact 1 name *

Emergency contact 1 phone number *

Relationship to child *

Parent

Neighbor

Friend

Family member (please indicate relationship) Family member (please indicate relationship)

Emergency contact 2 name *

Emergency contact 2 phone number *

Relationship to child *

Parent

Neighbor

Friend

Family member (please indicate relationship) Family member (please indicate relationship)

Health Card # *

Services

Choose program: (payments are done by E-transfer, other options available but a transaction fee will occur) *

40 days $2650

30 days $2065

20 days $1400

9 extra days $600 (optional Friday)

Payment Plan Needed? (half now half December 30 2023) *

yes

Interested in Trampoline training? *

yes

Interested In Extra Friday Training? *

yes

Compete In Competitions *

Yes

Development Camps *

Yes

Pre Season Training in Grouse or Whistler. For early season jump training and more (early December)! *

yes

Compete in extra contests aside from the main 3 (Whistler, Big White, Silver Star). Extra events include Air Nation events, BC games, Canada games, extra provincial events added *

Yes

If you chose "Yes" to the last question. Please select what extra contest you are interested in this season.

Air Nation slopestyle/Big air Sun Peaks Jan 16-18

Air Nation Jr. Nationals Blue Mountain March 4-7

Grouse provincial series (highly recommend)

BC Winter Games Feb 22-25

BC Snowboard

Add your BC Snowboard Membership here:

Canada Snowboard #

Waivers

Photo/Video Authorization and Release Form I the parent or Guardian of the athlete above give our consent to The Coast Club for photo/video use while attending Coast Club meetings. Authorize: The Coast Club coaches: Buddy Shirley, Andrew Matthews, Quinn Fogtmann, Api Ihaia and Jennifer Armstrong(the ‘Photographer’), to use: 1. film photographs 2. digital photographs 3. motion picture footage 4. audio recordings of my child (the ‘Materials’) in accordance with the following terms: THEME OF MATERIALS: The Materials that will be recorded and used with the understanding that the content or theme thereof will be the following: We need consent of all athletes for photo and video consent. For themes such as snowboarding, video analysis, photos and videos of athletes for there own sports profile, being featured on our clubs web/social media page, creating video edits for sponsors. LOCATION: The Materials will be recorded at or around the following location(s): We will only take photo/recordings while at training facilities mainly for training purposes or personal sports portfolio. Locations include home resort Mount Washington Alpine Resort, any resort we travel to for competition/events or training camps while were on hill or at any other training facilities we may attend (trampoline park, dryland training ect.) SCHEDULE: The approximate time during which the Materials will be recorded is: We could use photography or recordings at any of our meetings as a club. REPRODUCTION AND USE: coaches; Buddy Shirley, Andrew Matthews, Quinn Fogtmann, Api Ihaia and Jennifer Armstrong has the unrestricted right and permission to use, re-use, publish, and republish the Materials in all forms of media (including printed materials) , promotional purposes (including, but not limited to, advertising, publicity, commercial, or display use). RELEASE OF CLAIMS: Further, I hereby release and discharge to coaches: Buddy Shirley, Andrew Matthews, Quinn Fogtmann, Api Ihaia, Jennifer Armstrong and all persons functioning under his/her permission or authority (including, but not limited to, associates, affiliates, officers, agents, advertising agencies, designated directors, employees, and customers) from any claims. I have read the foregoing and fully understand the contents hereof. I represent that I am the parent or guardian of the above named Athlete. For value received, I hereby consent to the above on his/her behalf. Please check yes to continue *

Yes

Parents please make sure helmets are in good condition. One hard blow can seriously damage a helmet. Foul language cannot be tolerated. Club athletes must act respectfully toward others on the team and the public (including skiers!). It is important that we portray a good image of our club. Drug use before a session, while riding or during club activities (camps/events etc) is absolutely prohibited and will result in expulsion from the team - with no refund of registration fees. Liquor is also absolutely prohibited before a session, while riding or during club activities (camps/events/etc) by team minors and will result in expulsion from the team without refund. Snowboarding places rigorous physical demands on the body. Although it can be a safe sport, unexpected injuries may occur. Many injuries can be prevented by proper physical preparation (sleep and healthy food), suitable and properly adjusted equipment, and common sense. But some times injuries happen its snowboarding. Any athlete after a serious injury must be cleared by a doctor, before return to play. Our club has the properly certified coaches to keep our athletes safe and we take pride in that. As part of our agreement with the local moumtain, we have agreed that no athlete will ride on resort property or features, when the resort is closed to the public. Doing so may result in expulsion from the team and losing the resort industry/season pass. Members must be registered with BC Snowboard Association prior to attending any club activities. I understand and will follow club rules: *

Yes

Any Addition Information

Parent Signature *

clear