2020 Adult Application to Register Form Ottawa South United Soccer Association

Mailing Address: P.O. Box 362, Manotick, ON K4M 1A4 2020 ADULT APPLICATION TO REGISTER FORM OTTAWA SOUTH UNITED SOCCER ASSOCIATION www.osu.ca Player'slastname Player'sfirstname Address City Province Postal code Home Phone Cell Primary E-mail Gender M F Birth date year month day Where did you play in 2019? OSU DIDNOTPLAY OTHER Please state any medical issues we should be aware of: Do you carry an Epi-Pen? Yes No Are you a Goalie: Preferred Position: Years of Playing Experience: PLAYING HISTORY ATTENTION: The“PLAYING HISTORY” section MUST be completed –Any person who provides falseinformationor withholds any of the required information will be suspended from all Ontario Soccer Association activities for one year. Has the player ever registered to play soccer in another country? Yes No If YES, answer the following questions: a) In which country (other than Canada) did the player last register? b) With which Club did the player last register in another country? c) In which year did the player last register in another country? Early fee Regular fee Late Fee Adult Recreational OSU Leagues (until March 5) (begins March 6) (begins April 6) Player Request: SaturdayMen’s (2002 and earlier) $238 $ 278 $298 Will you be leaving the area in September? Yes No ThursdayWomen’s - (2002 andearlier) $208 $ 248 $268 Friday Women’s 30+ - On the Green (1990 and earlier) $188 $ 228 $ 248 Early fee Regular fee Late fee Adult Leagues (OCSL / Other) (until March 5) (begins March 6) (beginsApril 6) 2020 Coaches Name: Team Name: WOMEN Regional/Premier – WC1 2019 Coach_ _____________ $303 $ 343 $363 WC 2 – 5 2019 Coach $263 $ 303 $ 323 WR 1 – 6 2019 Coach $263 $ 303 $ 323 MEN Regional/Premier – MC1 2019 Coach _____________ $303 $343 $363 MC 2 – 5 2019 Coach $263 $ 303 $ 323 MR 1 – 6 2019 Coach $263 $ 303 $ 323 Oldtimers (1984 and earlier) 2019 Coach $273 $ 313 $ 333 Masters (1969 and earlier) 2019 Coach $273 $ 313 $ 333 “Help the kids playfund” Program Fee $ Eachyear,OSU receivesmany requeststo sponsorkids, to give them an opportunityto play soccer.In the past we have been able to support a few of those requests, but with your donation, we would be able to sponsor many more children who would otherwise not get the opportunity to participate in organized + Donation $ soccer. Thank you for your generous donation - it willmake a difference in these children’s lives. LEGAL LIABILITY AND CLUB INFO ON BACK. NSF & Returned Cheques - $40.00 administration charge and Net Paid $ potential player deregistration (makecheques payable to:OTTAWA SOUTH UNITED S.A.or OSU) CASH CHEQUE# Officeuse only Signature Date ONTARIO SOCCER ASSOCIATION WAIVER AND RELEASE OF CONSENT FOR PERSONAL USE OF INFORMATION LIABILITY `(To be signed by players 18 yrs of age and older) I authorize the Canadian Soccer Association, Ontario Soccer Association By signing or submitting this form you give up important legal rights. (OSA), Eastern Ontario District Soccer Association (EODSA), and OSU to collect Please read carefully! This is a binding legal agreement. and use personal information about my child/ward for the purpose of delivering a quality soccer program and receiving relevant communications from any of the As a Participant in the programs, activities and events of the Ontario organizations listed above. I understand that I may withdraw such consent related Soccer Association, their Districts, Leagues and Clubs, the undersigned to receiving communications at any time by contacting the OSA Privacy Officer acknowledges and agrees to the following terms. (OSA Privacy Officer AT soccer.on.ca) or by mail to: Attention OSA Privacy The Ontario Soccer Association, their Districts, Leagues and Clubs, directors, Officer, Ontario Soccer Association, 7601 Martin Grove Road, Vaughan, ON L4L officers, members, employees, coaches, volunteers, officials, participants, clubs, 9E4. The privacy officer will advise the implications of such withdrawal. We do agents, sponsors, owners/operators of facilities, and representatives (the not sell or distribute your personal information to any other parties not listed “Organization”) are not responsible for any injury, damage or loss of any kind suffered by a Participant during, or as a result of, any program, activity or herein. event, caused in any manner whatsoever including, but not limited to, the negligence of the Organization. I further grant OSU the right to photograph and/or videotape me and/or my child or ward and further to display, and use photographs and/or videotapes on the IN CONSIDERATION of my participation as a Participant in such programs, OSU website or in media events. I understand that I may withdraw such consent by activities and events, I hereby acknowledge that I am aware of the risks and contacting the club at the address below. hazards associated with or related to soccer. The risks and hazards include, but are not limited to, injuries from: o Executing strenuous and demanding physical techniques in soccer OTTAWA SOUTH UNITED SOCCER ASSOCIATION o Dryland training including weights, running, and massage PRIVACY POLICY Grass, turf, and other surfaces including bacterial infections and rashes o Last Updated: January 12, 2011 o Falls to the ground due to uneven or irregular terrain or surfaces o Collisions with walls and soccer equipment The Ottawa South United Soccer Association (OSU or the Club) is committed to Failure to properly use any piece of equipment or from the mechanical protecting your privacy. You can visit most pages on our Web site without o providing us any information about yourself. On some of our pages we do failure of any piece of equipment require personal information from you. This privacy statement explains our policy o Extreme weather conditions which may result in heatstroke, related to the collection, storage and distribution of this information. sunstroke, orhypothermia o Contact, colliding or being struck by other participants, spectators, What do we collect? equipment, or vehicles On pages where we do require personal information from you we will clearly state o Vigorous physical exertion andstrenuous cardiovascularworkouts o Exerting and stretching various muscle groups that we are collecting this information and will provide a link back to this privacy o Travel to and from competitive and/or non-competitive events and activities statement. Most often this information is required for registration purposes, and which are an integral part of the organization's activities as such includes demographic information used to contact you by regular mail, email or telephone. It also includes information required to deliver a quality soccer FURTHERMORE, I am aware that I may: program. This may include, but is not limited to, program selection, age, gender, • Sustain injuries in soccer that can be severe, cause spinal cord injuries and even position, ability, equipment sizing, location preferences, and friend requests. In be fatal addition, emergency medical information is required should an accident occur and • Experience anxiety while challenging myself during the activities, events, and medical assistance need to be provided. Any online financial transactions are programs processed by a secure third-party, and no information other than the amount paid • Come into close contact with other participants, including the possibility of and the date and type of payment are delivered to the Club. accidental and unexpected contact • Risk of injury is reduced if I follow all rules established for participation How is your information used? • Risk of injury increases as I become fatigued Your personal information is used for the following purposes: IN CONSDIERATION of the Organization allowing me to participate as a to ensure our site is relevant to your needs Participant, I agree: To assume all risks arising out of, associated with or related to • to deliver a quality soccer program, my participation; To be solely responsible for any injury, loss or damage that I including building team rosters might sustain while participating; and to release the Organization from liability for • for coaches and other team volunteers to contact their any and all claims, demands, actions and costs that might arise out of my players participating, even though such risks, injuries, loss, damage, claims, demands, • to alert you to important dates, events and meetings actions or costs may have been caused by the negligence of the Organization. • to register with the Club for a specific program • we occasionally hire other companies to provide limited services on our Accident Insurance: Executing this agreement will not preclude you from accident behalf including mailing newsletters. We will only provide those companies with insurance coverage, subject to the terms and conditions of The Ontario Soccer the information they need to deliver the service, and they are prohibited from Association's insurance policy. using that information for any other purpose. REGISTRATION AND REFUND POLICY - APPLIES TO ALL PLAYERS OSU may disclose your personal information if required to do so by law or in the Payment ofRegistration Fees good-faith belief that such action is necessary to: • Full payment for registration must accompany the registration form • conform to the edicts of the law or comply with legal process served on OSU • Payment must be cash, cheque, debit, or credit card (where available) or the site; • Payment is made out to Ottawa South United or OSU • protect and defend the rights or property of OSU and its • Every player is responsible for their own registration and payment of fees website, or • Ottawa South United S.A. shall NOT be responsible for any monies paid • act in urgent circumstances to protect the personal safety of the OSU to a team, team coach, or team official and shall not entertain requests for employees, users of OSU programs or services, or members of the public. any such refunds Control of your information Please take the time to familiarize yourself with our refund policies.

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