First name Last name. Address. City Postal Code. Address #2 (If applicable) Address. Gender Date of Birth / / Age at registration

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Pamela Thomas
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1 Taekwondo Team PARTICIPANT INFORMATION First name Last name Address City Postal Code Address #2 (If applicable) City Postal Code Address Gender Date of Birth / / Age at registration Home Phone Cell Phone Home Phone #2 Cell Phone #2 Allergies Health concerns Membership Number EMERGENCY CONTACT First name Last name Phone Number Cell Number

2 Taekwondo Team Registration PAYMENT OPTION Payment Options Option 1 $ Sept 10th, 2015 Option 2 (for families) $182.50/athlete Sept 10, 2015 $ / athlete November 10, 2015 * Fee s do not include HST INCLUDED IN REGISTRATION ADDITIONAL FEES Up to 5 classes / week Assigned coach at tournaments Access to Taekwondo Training Leadership development Uniform: $50.00 (if required) Sparring Equipment available to purchase Provincial and National Membership of $40 Local Competitions: approx $65.00/competition fee per event. Promotion Tests: (3 exams/season Variable increase per promotion) Camps $ * Fee s do not include HST

3 Terms and Conditions All Athletes must have a paid annual membership at Variety Village All athletes must submit their team fees in full prior to training There is no reimbursement of Team fees after one month of signing/training. All Athletes must have full sparring equipment All athletes will register and pay for their competitions All athletes are responsible to cover all of their travel/accommodation expenses All athletes are responsible to act in a manner that is both respectful and responsible Overview At this level, we will continue to reinforce fundamentals with emphasis on consolidating sport specific skill. Training will include speed drills, aerobic and anaerobic and high section kicking will be introduced. This stage coincides with the start of the high performance pathway and specialization. Our Goal is for the student/athlete to accomplish the following: Demonstrate consistent dojang etiquette and commitment to Taekwondo practice Participate in Taekwondo Competitions as encouraged by the Instructors and Coaches Continue to develop and showcase fundamentals at grading and testing with the intent of obtaining his/ her Black Belt level. Continue to develop and showcase black belt fundamentals at grading and give back to the branch through volunteer/staff support Code of Conduct: Athlete As a student representing the V.V. Taekwondo Club, you must arrive on time for all practices, dressed in proper uniform, show a positive effort forward in all practices and games and give the proper respect to your coaches on/off the floor. Students training at the Train to Train level should be attending 3 classes per week. Students will attend two summer training camps at Variety Village and or Headquarters, participating at local available competitions and attend various training camps. (with approval of Grandmaster Young Su Choung, and Young Choung Taekwondo Academy).

4 Code of Conduct: Coach When you join the Variety Village Taekwondo Program you will see staff and coaches who are passionate, purposeful and strong advocates of sport. Our philosophy is to empower athletes to become their best within sport. This empowerment will become the base for athletes as they work to becoming great leaders within their communities. As coaches, we will model the way for athletes; creating strong structures, standards and assessment methods in an environment that is athlete centered. We also believe that in order to inspire athletes we must also be committed to the sport as Life Long Learners; each of the coaches have set their own goals that challenge their mind, body and spirit. The Head Coach is directly responsible for the program. The Head Coach is an employee of Variety Village and as such follows the policies and procedures outlined by V.V. The coaches also abide by the Code of Ethics and Conduct as outlined by the Coaches of Canada. Coaches shall: Show respect to everyone involved in the program Encourage positive behavior during practices/competitions Ensure everyone is included in all activities at all times Model the way athletes will follow our lead Assume responsibility of monitoring students during practices/competitions Monitor and intervene in any and all disagreements between any and all students Be involved in the discipline process if necessary Trouble shoot where applicable

5 Parent/Guardian Commitment As the Parent representing the Variety Village Taekwondo Club, you must arrive on time for all practices, assist your child with the uniform (if necessary) and show the proper respect to the coaches on/off the floor. Parents are available to speak with the coach(s) prior/following the class. Parents are invited to observe the class and must remain in the sitting area. The mats are for the students/coaches/volunteers only. A paid annual membership at Variety Village is required for each participating team member Communicate with the coaches prior to/following practices only. Commit to the length of the practice and send participant ready to train All participants are encouraged to participate at competitions and promotion testing. If I foresee any problems with attendance at these meets I will talk to the Head Coach Participants may be suspended or removed from the team for unexcused absences or chronic tardiness to practices There is no reimbursement of fees after one month of signing training

6 Communication The Club Coaches guide the program to the best of their ability. Should there be any concerns with a coach, student or a volunteer the procedure to follow is; 1. First speak to the coach concerned if not satisfied 2. Speak to the Head Coach Rommel.cabanatan@gmail.com if not satisfied 3. Contact Ms. Manager for the Variety Village Athletic Club ext Contact Mr. Rafael Polinario Director for the Variety Village Athletic Club ext. 243 Medical Release Form The undersigned (Parent/Guardian(s)) hereby irrevocably appoint the Variety Village Athletic Club and its members and employees and my/our agent to authorize any necessary medical treatment for: from time to time throughout the period commencing September 1, 2015 and ending August 31, 2016 while the participant is under the care and supervision of the club. The undersigned further releases the club and its members, volunteers, trustees, employees and agents from any liability for any damage or injury of any type cause to the participant in connection with any dealings and associations with the Club including the authorization of necessary medical treatment as referred to herein. Please note: Due to insurance requirements, all participants must be fully registered before they can participate in training. Print Name Signature

7 Consent and Waiver I recognize the risk of injury or potential health risk that may be involved in participation in the named membership, program, activity, event or volunteer opportunity, I hereby willingly assume such risk of injury or health risk for myself or for the named person(s) for whom I am in law responsible and assume full responsibility during and after my/their participation in the program, activity or event. In consideration of the acceptance of my application and the permission to participate in the membership, program, activity, event or volunteer opportunity, I, for myself, my heirs, executors, administrators, successors and assigns, HEREBY RELEASE AND WAIVE, AND FOREVER DISCHARGE Variety The Children s Charity (Ontario), Variety Village, all other organizations, associations, companies associated with any of the programs offered by Variety Village, and their respective agents, employees, officials, servants, contractors, representatives, elected and appointed officials, successors and assigns OF AND FROM ALL claims, demands, damages, costs and actions whatsoever and howsoever caused, arising or to arise by reason of my participation the program, activity, event or any of its associated activities. I also hereby give permission to Variety The Children s Charity (Ontario), Variety Village, and all other associated organizations, associations and companies for the unrestricted right to take, use and publish my photograph, image and likeness in publications, promotional materials, website, video broadcasts, and any other communication vehicles, including electronic forms, at their discretion. Further, Variety The Children s Charity, Variety Village and all other associated organizations, associations and companies shall have complete ownership of the photographs and images as they deem appropriate for purposes including, but not limited to, the promotion or illustration of their programs and activities. I release Variety the Children s Charity, Variety Village and all other associated organizations, associations and companies and all of their directors, officers, employees and agents from liability claims and costs of whatever kind occurring in connection with being photographed and/or video taped or from the use of the images obtained therefrom. I also recognize that membership is a contract between myself and the named person(s) for whom I am in law responsible and Variety The Children's Charity, Variety Village and all other associated organizations, associations and companies. I, for myself and for the named person(s) for whom I am in law responsible agree to pay the full term of the contract. I understand and agree to all of the above terms and conditions: Print Name Signature (Parent or Guardian if under 18) Please note: All information shared with Variety is treated with the strictest confidence in adherence with the Personal information Protection & Electronic Documents Act Applicants may be requested to respond to inquiries from a representative of Variety Village Please review all terms and conditions of membership before applying

8 This is to confirm that I have read and agree to follow the terms and conditions and the Code of Conduct outlined in this contract. VVAC Team Print Name Signature Signature (Parent or Guardian if under 18) Date OFFICE USE ONLY Date Received Verified By

REGISTRATION FORM 2018

STUDENT: REGISTRATION FORM 2018 *Please note registrations are accepted on a first come first served basis. All sections on registration form must be completed. PARENT/GUARDIAN: Date of Birth: (yyyy/mm/dd)