2010 Ottawa Training Program Registration

Name:		Year of Birth:
Phone Number:		Emergency Contact Name:
Email Address:		Emergency Contact Number:
Address:		OHIP Number:
Address:		Any medical conditions or allergies that we should be aware of?

WAIVER

IN CONSIDERATION OF the acceptance of my entry into the Junior Program of the Ottawa Orienteering Club , on behalf of myself, my heirs, executors, administrators, assigns and personal representatives, I HEREBY RELEASE AND FOREVER DISCHARGE the officials and all organizers, the Canadian Orienteering Federation, Orienteering Quebec, the Ottawa Orienteering Club, and any landowners whose property is used , any and all sponsors, any affiliated or contributing clubs, associations, individuals, or corporations, all participants, their respective agents, representatives, employees, successors and assigns from ANY AND ALL actions, claims, costs, and expenses in respect of any injury, death, loss or damage to my person or property of any kind or nature, however caused, which may be suffered or incurred, directly or indirectly, relating to or arising from my participation in this program.

I am fully aware of the physical risks of injury inherent in the sport of orienteering and I voluntarily agree to accept full responsibility and legal liability for any injury or damages which result from my assumption of these risks. I am physically fit and fully capable of participation in the events associated with the Junior Program.

DATE: .................................................

Signature(s): .......................................................

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(Parents or Guardian must sign if participants are under 18 years of age.)