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The other policies related to The Gazelles Cross Country Club can be seen in our Vision Policy Statement.
For liability purposes, registration forms and all waivers must be completed and Registration Coaching Fees must be paid prior to commencement of training.
All meet fees must also be paid prior to commencement of the meet.
General Family Information:
City & Postal Code:
Athlete Information (Athlete 1):
First and Last Name:
Date of Birth (DD/MM/YYYY):
School Grade: ---123456789101112
Cell Phone & Email (Optional):
Athlete Information (Athlete 2):
Gender: (Male/Female) MaleFemale
All information received on this form will be treated as strictly confidential. Please fill out completely and accurately. This information is
essential to helping us develop a program that addresses your child’s goals and interests and is safe and effective.
AsthmaFainting SpellsHistory of Head InjuriesRheumatic FeverChronic NosebleedFeet or Leg problemsMigraine SeizuresDiabetesHemophilia/Bleeding disordersRash SleepwalkingDigestive upsetsHeart problemsRecent illness or operationUrinary infectionsEar, Nose, Throat infectionsHerniaDislocated shoulder; swollen, painful joints; ‘trick or lock’ knee or other joint disability
Give details of usual treatment for each of the above conditions indicated:
Please explain if your child/ward has any medical condition that requires any modification of his/her program.:
Please list all known confirmed allergies to the following:
If foods are life-threatening, please explain the symptoms and the treatment:
(c) Other (e.g., bee or wasp stings, environmental allergies):
Has your child/ward suffered any serious allergic or asthmatic reaction?YesNo
If yes, please provide details, including the type and severity of reaction:
Is allergy considered: MildModerateSeriousLife-Threatening
Has a doctor prescribed an Epi-Pen for your child/ward? YesNo
Has a doctor prescribed an inhaler for asthma? (Prescribed asthma inhalers must be carried by the child during training.) YesNo
Has a doctor prescribed an inhaler for any other reason? YesNo
Please list any foods your child/ward should not eat for medical, dietary, or religious reasons:
Does your child/ward take prescribed medication on a regular basis? Please specify:
What prescribed medication(s) should your child/ward have with him/her during training?
(1) Does your child/ward wear or carry medical alert identification (e.g., bracelet)? YesNo
If yes, please specify what is written on it:
(2) Does your child/ward have any other relevant medical condition that will require modification of the program? YesNo
If yes, please explain:
Should it become necessary for my child/ward to have medical care, I hereby give the coach permission to use her/his best judgment in obtaining the best of such service for my child/ward. I also understand that in the event of such illness or accident, I will be notified as
soon as possible.
IN CONSIDERATION of the acceptance of my application and the permission to participate as an entrant of membership, practice, competition, or any other event as part of The Gazelles XC Club and Running For Your Life Inc., during the season for which I am registered, I, for myself, my heirs, executors, administrators, successors and assigns HEREBY RELEASE, WAIVE AND FOREVER DISCHARGE The
Gazelles XC Club, Running For Your Life Inc., Athletics Ontario, Minor Track Association (MTA) and all other associations, sanctioning bodies and sponsoring companies, and all other agents, officials, servants, contractors, representatives, successors and assigns OF AND FROM ANY AND ALL CLAIMS, demands, damages, costs, expenses, actions and causes of actions, where in law or equity, in respect of death, injury, loss or damage to my person or property, HOWEVER CAUSED arising or to arise by reason of my participation in said, whether as a spectator, participant, competitor or otherwise; whether prior to, during or subsequent to any such event and NOTHWITHSTANDING that some may have contributed to or occasioned by the negligence of any of the aforesaid. I FURTHER UNDERTAKE TO HOLD AND SAVE HARMLESS AND AGREE TO
INDEMNIFY all of the aforesaid from and against any and all liability incurred by any or all of them arising as a result of, or in any way connected with my participation in the said event. By submitting this entry, I acknowledge having read, understood and agreed to the above waiver, release and indemnity. I warrant that I am physically fit to participate as a member of The Gazelles Track and Field Club.
I, the undersigned, do hereby consent and agree that Running for Your Life, its employees, or agents have the right to take photographs, videotape, or digital recordings of me while training with Running for Your Life and to use these in any and all media, now or hereafter known, and exclusively for the purpose of a video and/or picture displaying activities, training, coaching, mentoring and testimonials. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.
I do hereby release to Running for Your Life Inc., its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.
I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.
I also understand that Running for Your Life Inc., is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.
(The Power of Attorney is used to allow you, the Donor (either athlete or parent/guardian of athlete), to appoint a representative to be your attorney and to sign Athletics Ontario & Minor Track Association entry forms, waivers etc. on your behalf)
I appoint all or any Staff and/or Gazelle Coach of Running For Your Life Sports Performance Group / The Gazelles, jointly and severally, to be my attorney(s) in accordance with the Powers of Attorney Act and to do on my behalf anything that I can lawfully do by an Attorney.
This power of attorney is subject to the following conditions and restrictions: This Power of Attorney shall only apply to enable my said attorney(s) to execute such entry forms, waivers and other documents as may be required to permit me or the Athlete named above to participate in any event sponsored or sanctioned by Athletics Ontario & Minor Track Association during the /2018 calendar years commencing January 1st 2018 ending on August 31st, 2018.
I hereby acknowledge that by signing such entry forms, waivers and other documents that my attorney(s) may WAIVE ANY AND ALL CLAIMS that I, the Athlete Named Above, my heirs, executors, administrators, successors and assigns may have against The Gazelles XC Club, Running For Your Lfe Inc., Athletics Ontario & Minor Track Association and its respective agents, officials, employees, contractors, representatives, successors and assigns with regard to ANY demands, damages, costs, expenses, actions and causes of action, whether in law or equity, in respect of death, injury, loss or damage to my person or property HOWSOEVER CAUSED arising or to arise by reason of my participation or the participation of the Athlete Named Above in any Gazelles Track & Field, Running For Your Life Inc., Athletics Ontario & Minor Track Association sponsored or sanctioned event in the said 2018 calendar year, whether prior to, during or subsequent to any such event and NOTWITHSTANDING that same may have been contributed to or occasioned by the NEGLIGENCE of any of the aforesaid.
I represent that I am at least 18 years of age, have read and understand the foregoing statements of Waiver, Media Releases and Power of Attorney above and am competent to execute this agreement.I am the parent and/or legal guardian of the child being filmed and understand the foregoing statements of Waiver, Media Releases and Power of Attorney above, and am competent to execute this agreement
I agree to the above stated policies.
Payment: Pay with PayPalPay In Person
The Gazelles XC is a division of Running for Your Life Inc.
Membership Fees For New Members
The above fees do not include Indoor Venue Rental Fees for the Indoor Season. Indoor Fees are typically $25 a month/$125 Total for Grade 6 and under members, $35 a month/$175 Total for Grade 7 – 8 members and $40 a month/$200 Total for Grade 9 and above members based 5 months of indoor venue use. These estimates are subject to change based on venue costs. Fundraising initiatives will be used to help subsidize venue fees.
*Meet Fees will be handled separately from Registration Fees. Meet fees are the responsibility of the athlete and/or parent.
!Please keep in mind each Season (Indoor & Outdoor) have their own separate fee.
New Members will receive a Team Singlet and T-Shirt as part of the Registration fee as well as Track Suit.
There is a 10% discount if full year (Indoor + Outdoor Season) is paid at the beginning of season in September and if siblings join. Tax Receipts will be provided in January of the following year.
The above fees do not include Indoor Venue Rental Fees for the Indoor Season. Indoor Fees are typically $25 a month/$125 Total for Grade 6 and under members, $35 a month/$175 Total for Grade 7 – 8 members and $40 a month/$200 Total for Grade 9 and above members based on 5 months indoor venue use. These estimates are subject to change based on venue costs. Fundraising initiatives will be used to help subsidize venue fees.
*Meet Fees will be handled separately from Registration Fees. Meet fees are the responsibility of the athlete and/or parent.
It is assumed Returning Members already have the Track Suit and are members of their age related Track & Field Associated Governing Body. If not this additional association fee will be added from the chart above.
There is a 10% discount if full year (Indoor + Outdoor Season) is paid at the beginning of season in September and if siblings join.
Tax Receipts will be provided in January of the following year.
The Gazelles Track & Field Club Vision Statement
From putting Athlete experience first, to coaching, to integrated support services, to ed- ucation – The Gazelles Track & Field Club strives to provide an environment in which all Track and Field athletes can grow, develop and flourish.
The Gazelles Track & Field Club Core Value
The Gazelles Track & Field Club is a club that is founded on key values and principals. It is our mission to raise and empower the young people amongst us to embrace these vir- tues in all they do. It is also our expectation that all of our Coaches, Members and Par- ents will also embrace these values and embody them in their support of our Athletes.
We value Integrity – Telling the truth to oneself and believing in doing what is right. We expect our members to be Honorable in all they do. To be Positive and Forthright. We expect our members to be Kind, Genuine and Empathetic. To be Compassionate, Accepting and Tolerant of one another. To have the Courage and Determination to take on the challenges that lay ahead. We expect our members to have Perseverance, Trust and Vision when times get challenging.
Our PURPOSE is to help to shape the talents of ALL of our athletes in the Gazelle Track & Field Club – building championship performers. As part of this overarching aim, we are committed to an education program which nurtures and develops both ath- letes and coaches within our sport, assuring professionalism and continued growth at all levels of athletic development.
Our sport is one of the very best sports around. It deserves a commitment on all levels to bring Track & Field back to it’s notoriety. The Gazelles Track & Field Program spe- cializes in maximizing the potential of its club members on and off the competition field. To accomplish this feat, it is our priority to put the needs of our Athletes and Members first. We believe in equal opportunity and equal treatment of all its members. We believe that the sport of Track & Field is a global phenomenon that originates in the cultivation of local talent. Not every member will win a gold medal but every member has the ability to perform at their very best through smart training and developing a passion for the sport.
We acknowledge the high importance of parents being involved in their children’s sport- ing lives and we welcome this involvement with open arms. With that being said the Vi- sion Statement and Principles outlined below are elements that we believe will help The Gazelles Track & Field Club Program become the very best program for each and every Athlete.
The Gazelles Track & Field Club Beliefs
• Athletes should come to practice with a good attitude and ready to work. Athletes should have all necessary clothing and shoes and be ready to start on time.
The Gazelles Track & Field Club Meet Expectations:
Membership fees which include Coaching fees, Gazelle Uniform, Association Membership Fees and Venue fees* (Indoor Season only*). Fees are due in full at the beginning of the season. Membership fees include training/coaching of your Athlete for the duration of the season. New Members will receive a competition singlet and T-Shirt. VENUE FEES ARE NOT PART OF THE MEMBERSHIP FEES AND ARE THE SOLE RESPONSIBILTY OF THE MEMBERS.
Our Gazelle Performance Incentive Program is designed to reward exceptional Athletes who show outstanding results in their Track & Field performances.
It is our hope to reward these Athletes with financial incentives and promotional materials/clothing to support Athletes who strive for excellence and high performances.
This program is geared specifically towards Athletes who meet the following criteria:
We also aim to recognize Gazelle Athletes who conduct themselves in a professional leadership role, show outstanding character and competitive drive and exhibit extreme focus and discipline at all Gazelle practices and meets.
This program is designed to help parents and Student – Athletes walk thru the maze of information so that the path of Post High School Education and Athletic Competition is clear. The program puts the Student – Athletes in front of potential Schools so the the Student – Athletes have the highest chance of being discovered by potential schools. Our mission is to help parents and Student – Athletes make the best decision in choosing a school that fits their individual Athletic and Scholarly needs.