JACKRABBIT REGISTRATION FORM 07/08

 - cost for registration for the season is $40 or $90 max. per family

(subtract $5./child for GNSCC members maximum total = $80)

(Please make cheques payable to G.N.S.C.C.-there is a $25. fee for nsf cheques)

Name: ________________________ Age: _______ Last yrs. level_____

Name: ________________________ Age: _______ Last yrs. level_____

Name: ________________________ Age: _______ Last yrs. level_____

Address: __________________________________________________

Town:  ________________________________________________

Postal Code: __________

Phone: _______________(res.) ________________(work)

This Waiver must be signed and dated when registering! I HEREBY AGREE to abide by the rules and Regulations of Cross Country Canada (hereinafter called the CCC), Southern Division (hereinafter called Division) and to participated in the events, activities, and programs sanctioned by CCC and Division in accordance with the Associations Rules, Regulations and by-laws.

IN CONSIDERATION OF CCC, Division, and the Georgian Nordic Ski and Canoe Club Inc., acceptance of me as a registered member of the Association and by being permitted to take part in the Associations events, activities and programs, I hereby, for myself, my heirs, executors, administrators and assigns, forever release, discharge and hold harmless CCC, Division, Georgian Nordic Ski and Canoe Club Inc., its directors, officers, employees, representatives or agents and all land owners on the trail system.

Signature: _______________________

Date: __________

 Parent or guardians signature to cover all minors named above

_____________________________________________________________

On occasion we may wish to send you information or reminders using E-mail.  If you wish to receive communications from Jackrabbits please fill in the information below.

Name of parents &/or guardians:    

     _____________________________________       ___________________________________________

Important Note:  Please indicate below if there is any particular condition about your child that the group leader should be informed of {eg: peanut allergy }

    _____________________________________________________________________

    _____________________________________________________________________