2020-2021 Membership Application Form Royal Canadian Curling Club
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2020-2021 MEMBERSHIP APPLICATION FORM ROYAL CANADIAN CURLING CLUB Name: ________________________________________________ Address: _____________________________________________ ________________________________________________________ Postal Code: _________________ Telephone: Main: _______________________________ Other: _____________________ Email: ____________________________________ PLEASE INDICATE THE LEAGUE IN WHICH YOU WISH TO CURL: NOTE: All fees include HST, Prize Fund, and OCA charges. If you are curling in another league(s), you will pay the fee for the highest priced league plus the Additional Night Fee(s) of $ 250.00 for each additional evening leagues or $200.00 for each additional daytime league (includes HST & Prize Fund). CURLING ACTIVITY FEES: EVENING LEAGUE FEES: THURSDAY NIGHT MENS $ 524.00 $____________________ TUESDAY NIGHT MIXED $ 524.00 $____________________ WOMENS (WEDNESDAY) $ 524.00 $____________________ FRIDAY NIGHT MIXED $ 514.00 $____________________ SUNDAY NIGHT MIXED $ 514.00 $____________________ MONDAY OPEN $ 484.00 $____________________ MONDAY OPEN DOUBLES $ 308.00 $____________________ 1st ADDITIONAL EVENING LEAGUE FEE $ 250.00 $____________________ 2nd ADDITIONAL EVENING LEAGUE FEE $ 250.00 $____________________ DAYTIME LEAGUE FEES: TUESDAY AFTERNOON $ 320.00 $____________________ THURSDAY AFTERNOON $ 320.00 $____________________ ADDITIONAL DAYTIME LEAGUE FEE $ 200.00 $____________________ LOCKERS $ 50.00 $____________________ SOCIAL/TEAM HOLD FEE** $ 100.00 $____________________ ACTIVITY FEES TOTAL: $____________________ **Social fee is payable to keep your membership active, should you choose not to curl in 2020/2021 Team Hold fee (non-refundable) is payable by everyone on a team in order to keep their spot for the 2021/2022, should the team not be returning in 2020/2021. Please complete reverse INITIATION FEE Payable by anyone curling in a regular league at Royals except: 1. Owner Members 2. Members who have already paid the initiation fee in full 3. Senior Members (65 or older on June 30, 2020) 4. Student Members (under 25 on June 30, 2020 and a full-time student) Select from one of the two payment options: 1. Lump-sum payment of $600 OR 2. Annual Payments of $65 to a maximum of 10 payments INITIATION FEE TOTAL: $____________________ ACTIVITY FEES TOTAL (from other side) $____________________ GRAND TOTAL OWING: $____________________ Make Cheques Payable to: The Royal Canadian Curling Club. 131 Broadview Avenue Toronto, ON M4M 2E9 CREDIT CARD PAYMENTS: I authorize ALL charges on my account be transferred to my credit card on or around the first day of each month. VISA □ MasterCard □ Amex □ Card Number ___________________________________________________________ Expiry_____________ Name on Card: ________________________________________________ Signature: ________ ______________________________________ If you are already on a team, please list all team members If you are signing up as an individual, please indicate position(s) you are willing to play League Skip Third Second Lead _____________ ______________ ______________ _____________ _____________ _____________ ______________ ______________ _____________ _____________ _____________ ______________ ______________ _____________ _____________ DECLARATION OF COMPLIANCE – COVID-19 Individual Name (print): Email: Telephone: WARNING! ALL INDIVIDUALS ENTERING THE FACILITY AND/OR PARTICIPATING IN SANCTIONED ACTIVITIES MUST COMPLY WITH THIS DECLARATION Curling Canada, Royal Canadian Curling Club, CurlON, Toronto Curling Association, (collectively the “Organization”) require the disclosure of exposure or illness is in order to safeguard the health and safety of all participants and limit the further outbreak of COVID-19. This Declaration of Compliance will be kept safely, and personal information will not be disclosed unless as required by law or with your consent. An individual (or the individual’s parent/guardian, if the individual is younger than the age of majority) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services. I, the undersigned being the individual named above and the individual’s parent/gu ardian f(i the individual is younger than the age of majority), hereby acknowledge and agree to the terms outlined in this document: 1) The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is extremely contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document. 2) The individual has not been diagnosed with COVID-19; OR If the individual was diagnosed with COVID-19, the individual was cleared as noncontagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed. 3) The individual has not been exposed to a person with a confirmed or suspected case of COVID-19; OR If the individual was exposed to a person with a confirmed case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed. Declaration of Compliance – Covid-19 1 4) The individual is attending or participating voluntarily and understands the risks associated with COVID-19. The individual (or the individual’s parent/guardian, on behalf of the individual (when applicable)) agrees to assume those risks, including but not limited to exposure and being infected. 5) The individual has not, nor has anyone in the individual’s household, experienced any signs or symptoms of COVID-19 in the last 14 days (including fever, new or worsening cough, fatigue, chills and body aches, respiratory illness, difficulty breathing, nausea, vomiting or diarrhea, pink eye, or loss of taste or smell). 6) If the individual experiences, or if anyone in the individual’s household experiences, any signs or symptoms of COVID-19 after submitting this Declaration of Compliance, the individual will immediately isolate, notify the Organization, and not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced. 7) The individual has not, nor has any member of the individual’s household, travelled to, or had a lay-over in any country outside Canada, or in any province outside of Ontario in the past 14 days. If the individual travels, or if anyone in the individual’s household travels, outside Ontario after submitting this Declaration of Compliance, the individual will not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since the date of return. 8) The individual is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, adhering to recognized hygiene best practices, and otherwise limiting exposure to COVID-19. 9) The individual will follow the safety, physical distancing, and hygiene protocols of the Organization. 10) This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required. 11) The Organization may remove the individual from the facility or from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the individual is no longer in compliance with any of the standards described in this document. Date: Signature: Individual (If the age of majority) Signature: Date: Parent/Guardian (if the individual is younger than age of majority) Declaration of Compliance – Covid-19 2 CURLING CANADA - RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT to be executed by participants over the Age of Majority WARNING! Please read carefully. By signing this document, you will waive certain legal rights – including the right to sue 1. This is a binding legal agreement. Clarify any questions or concerns before signing. 2. As a participant in the sport of curling and the activities, programs, classes, services provided and events sponsored or organized by: Curling Canada Royal Canadian Curling Club CurlON Toronto Curling Association including but not limited to: games, tournaments, practices, training, personal training, dry land training, use of strength training and fitness conditioning equipment, machines and facilities, nutritional and dietary programs, orientational or instructional sessions or lessons, aerobic and anaerobic conditioning programs (collectively the “Activities”), the undersigned acKnowledges and agrees to the following terms outlined in this agreement: Disclaimer 3. Curling Canada Royal Canadian Curling Club CurlON Toronto Curling Association and their respective Directors, Officers, committee members, members, employees, coaches, volunteers, officials, participants, agents, sponsors, owners/operators of the facilities in which the Activities taKe place, and representatives (collectively the “Organization”) are not responsible for any injury, personal injury, damage, property damage, expense, loss of income or loss of any Kind suffered by a Participant during, or as a result of,