KENNEBECASIS PADDLING CENTRE
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Competitive Program Details
COMPETITIVE REGISTRATION U21
Paddler's Information
*
Indicates required field
Paddler's Name
*
First
Last
Birth Date
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yyyy/mm/dd
Sex
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Male
Female
Other
Address
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Line 1
Line 2
City
State
Zip Code
Country
Program
Competitive
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Jumpstart - $315
Spring Competitive A - $440
Summer Competitive A - $540
Summer Competitive B - $510
Fall Competitive - $300
Winter Competitive - TBD @ Forfitness
ADCKC Racing Fees
*
U10 - $58.50
U12 - $68.50
U14 - $75
U16 - $101
U18+ - $101
Racing fees are required if racing in Nova Scotia.
Non-refundable after July 8, 2023.
Please ensure you add the correct fees to the shopping cart on the next page once this form is submitted.
Medical Information
Medicare #
*
Expiry Date
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Allergies or Medical Conditions
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Guardian Information
Name
*
First
Last
Relationship
*
Phone Number
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Email
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Name
*
First
Last
Relationship
*
Phone Number
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Email
*
Comments
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Terms of Agreement
WAIVER OF LIABILITY
1.
To become a member of the Kennebecasis Paddling Centre, the participant(s), his/her parent(s) and/or legal guardian(s) (collectively the "Applicants"), all of whom are signed below, agree that the Kennebecasis Paddling Centre and all of the directors, officers, employees and representatives shall have no legal liability whatsoever for any injuries or losses sustained by the Applicants resulting from attending the programs and events sponsored by the Kennebecasis Paddling Centre and the use of equipment and facilities of the Kennebecasis Paddling Centre.
2.
The Applicants agree to indemnify and hold harmless the Kennebecasis Paddling Centre and its respective directors, officers, employees and representatives against all liabilities whatsoever resulting from any injuries or losses as referred to in paragraph 1.
3.
The Applicants agree that this Waiver shall bind any servant, agent, invitee, guest, spectator, or any other person associated with the Applicants.
4.
The Applicants acknowledge that all the activities to be carried out by the Kennebecasis Paddling Centre have an inherent risk of personal injury, property damage and loss or theft of personal property and the Applicants acknowledge and confirm that they are well aware of and understand these risks and that the participant(s) is/are taking part in the activities at the Kennebecasis Paddling Centre voluntarily. The Applicants warrant that the participant is in good health and is able to freely participate in the activities carried out by the Kennebecasis Paddling Centre and health restrictions, if any, have been noted on the Registration Form.
5.
The Applicants agree to be bound by all the rules and regulations as may be published from time to time, which govern activities and the use of the facilities of the Kennebecasis Paddling Centre.
6.
Media: I hereby authorize any images or video footage taken of
my youth (under 18 years of age), in whole or in part,
individually or in conjunction with other images and video
footage, to be displayed on the Kennebecasis Paddling Centre website
and other official channels, and to be used for media purposes
including promotional presentations and marketing campaigns.
REFUND POLICY
6. If for whatsoever reasons the Kennebecasis Paddling Centre cancels the program that you have registered for, a full refund will be issued. Otherwise, two weeks prior to the registered program starting registration fees will not be refunded except for medical reasons, which must be substantiated by a medical certificate and refund will be less a $25.00 administration fee. CKC and ADCKC racing fees are non-refundable after July 7, 2023.
Canoe-kayak is a water-based sport. Please ensure your child is comfortable in and on the water.
Agreement
*
I have read this waiver and fully understand its terms.
Signed by Parent or Legal Guardian
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First
Last
Submit