2022 Registration Form (Mens and Womens) (St. Columban SC)

Print 2022 Registration Form (Mens and Womens)
  1. St. Columban Soccer Club
    Registration 2022 - Mens and Womens Teams


    St. Columban Soccer Club is a community based soccer organization that is committed to player development and fun for all skill levels. We are the home for soccer in Huron East and West Perth and our bordering municipalities. We are an inclusive organization that has a goal of providing the best soccer experience for players of all ages and all skill levels!

    This form is for players to register for the 2022 outdoor season for mens and womens teams.

    A separate form must be submitted for each player. There is no payment required at this time but you will be asked to submit payment prior to the start of the season. Please subscribe to News updates on our website to make sure you don't miss anything! 

    If you experience issues with this form or have any questions, email [email protected]

     
Player Info
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Parent Info (optional if player is over 18)
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Volunteering
  1. Name of volunteer
  1. WAIVER

    In case of injury, the player and parents or guardian herewith waive all claims of any nature against the St. Columban Soccer Club, Directors, Executive, Coaches, Managers and any volunteers.
  2. DECLARATION OF COMPLIANCE - COVID-19 - FACILITY USE

     
    WARNING!


    ALL INDIVIDUALS ENTERING THE FACILITY MUST COMPLY WITH THIS DECLARATION

    Ontario Soccer and its affiliated districts, leagues, clubs and teams, and St. Columban Soccer Club (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 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organizations facilities or participate in the Organizations activities, programs, or services.


    I,
    the undersigned, being the individual named above and the individuals parent/guardian (if the individual is younger than 18 years old), 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.

     

    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 or suspected case of COVID- 19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed.

     

    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 Organizations 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 layover in any country outside Canada in the past 14 days. If the individual travels, or if anyone in the individual’s household travels, outside Canada after submitting this Declaration of

    Compliance, the individual will not attend any of the Organizations 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 and local public health authorities, 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.

  3. INFORMED CONSENT AND ASSUMPTION OF RISK AGREEMENT - age of majority (18 years and older)

    1.      This is a binding legal agreement. Clarify any questions or concerns before signing. As a Participant in activities, programs, classes, services provided and events sponsored or organized by Ontario Soccer and its affiliated districts, leagues, clubs and teams and St. Columban Soccer Club and the sport of soccer, 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

    2. Ontario Soccer, its affiliated districts, leagues, clubs and teams, and St. Columban Soccer Club, and their respective directors, officers, committee  members,  members,  employees,  coaches,  volunteers,  officials,  participants,  agents, independent  contractors,  subcontractors,  sponsors,  owners/operators  of  the  facility  in  which  the Activities take place, , successors and assigns, and representatives (the “Organization”) are not responsible for any injury, property damage, expense, loss of income, damage or loss of any kind suffered by a Participant during, or as a result of, the Activities, caused in any manner whatsoever including, but not limited to, the negligence of the Organization.

     

    Description of Risks

    3.      I understand and acknowledge that:

    a)     The Activities have foreseeable and unforeseeable inherent risks, hazards and dangers that no amount of care, caution or expertise can eliminate, including without limitation, the potential for serious bodily injury, permanent disability, paralysis and loss of life;

    b)     The Organization may offer or promote online programming (such as webinars, remote conferences, workshops, and online training) which have different foreseeable and unforeseeable risks than in-person programming;

    c)      The Organization has a difficult task to ensure safety and it is not infallible. The Organization may be unaware of the Participant’s fitness or abilities, may give incomplete warnings or instructions, may misjudge weather or environmental conditions, and the equipment being used might malfunction; and

    d)     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; however, the Organization cannot guarantee that the Participant will not become infected with COVID-19. Further, attending the Activities could increase your risk of contracting COVID-19.

     

    4.      I am participating voluntarily in the Activities. In consideration of that participation, I hereby acknowledge that I am aware of the risks, dangers and hazards and may be exposed to such risks, dangers and hazards. The risks, dangers and hazards include, but are not limited to:

    a)     Health: executing strenuous and demanding physical techniques, physical exertion, overexertion, stretching, dehydration, fatigue, cardiovascular workouts, rapid movements and stops, lack of fitness or conditioning, traumatic injury, bacterial infections, rashes, and the transmission of communicable diseases, including viruses of all kinds, COVID-19, bacteria, parasites or other organisms or any mutation thereof.
    b)     Premises: defective, dangerous or unsafe condition of the facilities; falls; collisions with objects, walls, equipment or persons; dangerous, unsafe, or irregular conditions on grass, turf or other surfaces, extreme weather conditions; travel to and from premises
    c)      Use of Equipment: mechanical failure of the equipment; negligent design or manufacture of the equipment; the provision of or the failure by the Organization to provide any warnings, directions, instructions or guidance as to the use of the equipment; failure to use or operate the equipment within my own ability.
    d)     Contact: contact with soccer balls, other equipment, poles, stands, soccer equipment, nets, fences, or other persons, whether intentional or unintentional, is a common part of soccer programs, and may lead to serious bodily injury, including but not limited to concussions and/or other brain injury, or serious spinal injury.
    e)     Advice: negligent advice regarding soccer programs
    f)      Ability: Failing to act safely or within my own ability or within designated areas
    g)      Sport: the game of soccer and its inherent risks
    h)     Conduct: My conduct and conduct of other persons including any physical altercation between soccer participants
    i)       Travel: Travel to and from the Activities
    j)Negligence: My negligence and negligence of other persons, including NEGLIGENCE ON the PART OF THE ORGANIZATION, may increase the risk of damage, loss, personal injury or death. I understand that the Organization may fail to safeguard or protect me from the risks, dangers and hazards of soccer programs, some of which are referred to above.


    Terms

    5.      In consideration of the Organization allowing the Participant to participate in the Activities, I agree:

    a)     That my mental and physical condition is appropriate to participate in the Activities and I assume all risks related to my mental or physical condition;
    b) 
    That  when I practice or train in my own space, I am  responsible for my surroundings and the location and equipment that I select;
    c)      To comply with the rules and regulations for participation in the Activities;
    d)     To comply with the rules of the facility or equipment;
    e)     That if I observes an unusual significant hazard or risk, I will remove myself from participation and bring such to the attention of an Organization representative immediately;
    f)      The risks associated with the Activities are increased when I am impaired, and I agree not to participate if impaired in any way;
    g)      That it is my sole responsibility to assess whether any Activities are too difficult me. By commencing an Activity, acknowledge and accept the suitability and conditions of the Activity;
    h)     That I am responsible for my choice of protective equipment and the secure fitting of the protective equipment;
    i)       That COVID-19 is contagious in nature and I may be exposed to or infected by COVID-19 and such exposure may result in personal injury, illness, permanent disability or death and voluntarily agree to assume all of the foregoing risks.

    Release of Liability and Disclaimer

    6.      In consideration of the Organization allowing me to participate in the Activities, use its equipment and facilities, I agree:


    a)     That the sole responsibility for my safety remains with me;
    b)     To ASSUME all risks arising out of, associated with or related to my participation;
    c)      That I am not relying on any oral or written statements made by the Organization or its agents, whether in a brochure or advertisement or in individual conversations, to agree to be involved in the Activities;
    d)     To WAIVE any and all claims that I may have now or in the future against the Organization;
    e)     To freely ACCEPT AND FULLY ASSUME all such risks and possibility of personal injury, death, property damage, expense and related loss, including loss of income, resulting from my participation in the activities, events and programs of the Organization;
    f)      To FOREVER RELEASE AND INDEMNIFY the Organization from any and all liability for any and all claims, demands, actions, damages (including direct, indirect, special and/or consequential), losses, actions, judgments, and costs (including legal fees) (collectively, the Claims) which I have or may have in the future, that might arise out of, result from, or relate to my participation in the Activities, even though such Claims may have been caused by any manner whatsoever, including but not limited to, the negligence, gross negligence, negligent rescue, omissions, carelessness, breach of warranty, breach of contract and/or breach of any statutory duty of care of the Organization;
    g)      TO HOLD HARMLESS AND INDEMNIFY the Organization from any and all liability for any damage, loss, expense or injury to any third party resulting from my participation in the Activities.
    h)     To FOREVER RELEASE AND INDEMNIFY the Organization relating to becoming exposed to or infected by COVID-19 which may result from the actions, omission or negligence of myself and others, including but not limited to the Organization;
    i)       That the Organization is not responsible or liable for any damage to my vehicle, property, or equipment that may occur as a result of the Activities;
    j)      That negligence includes failure on the part of the Organization to take reasonable steps to safeguard or protect me from the risks, dangers and hazards associated with the Activities; and
    k)      This release, waiver and indemnity is intended to be as broad and inclusive as is permitted by law of the Province of Ontario and if any portion thereof is held invalid, the balance shall, notwithstanding, continue in full legal force and effect.


    Jurisdiction

    7.      I agree that in the event that I file a lawsuit against the Organization, I agree to do so solely in the province of Ontario, Canada and further agree that the substantive law of Ontario will apply without regard to conflict of law rules. I further agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect.

     

    Acknowledgement

    8.      I acknowledge that I have read and understand this agreement, that I have executed this agreement voluntarily, and that this agreement is to be binding upon myself, my heirs, spouse, children, parents, guardians, next of kin, executors, administrators and legal or personal representatives. I further acknowledge by signing this agreement I have waived my right to maintain a lawsuit against the Organization on the basis of any claims from which I have released herein.

     

  4. Rowan's Law Acknowledgement

     

    What is Rowan’s Law?

    Rowan’s Law legislation was passed by the Ontario Government in 2018. This legislation is named in memory of Rowan Stringer who tragically died in 2013 of Second Impact Syndrome, the result of suffering multiple concussions playing rugby three times in six days. The legislation is designed to create a safer environment for competitive athletes, children and youth to play sport.

    Knowing how to recognize the signs and symptoms of a concussion, and what to do if a concussion happens saves lives. The Ontario Government is committed to implementing Rowan’s Law by putting concussion safety information in the hands of people who need it most. Increasing awareness and changing conversations in sport, at school and in our homes, will result in a transformative change to the way in which concussions are managed in amateur competitive sport and beyond.

    A participant is subject to a Concussion Code of Conduct for each Sports Organization they register with. The St. Columban Soccer Code of Conduct and the appropriate Concussion Awareness Resources MUST be reviewed before you can participate.


    ALL PARTICIPANTS UNDER THE AGE OF 26, PARENTS OF PARTICIPANTS UNDER THE AGE OF 18, COACHES, TRAINERS, & MANAGERS MUST REVIEW THIS INFORMATION, AND ACKNOWLEDGE THEY HAVE DONE SO, BEFORE PARTICIPATING IN ANY ST. COLUMBAN SOCCER PROGRAM.


Signature
  1. Provide parent/guardian full name if participant is aged 17 or under or provide participant name if over 18
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    Printed from stcolumbansc.com on Thursday, May 26, 2022 at 3:12 AM