* Please select the appropriate session

* Athlete's shirt size

* Athlete Date of Birth

* Athlete's Gender

* Parent/Legal Guardian Full Name

* Parent/Legal Guardian Phone (reachable during session)

* Emergency Contact Name

* Emergency Contact Relation to Athlete

* Emergency Contact's Phone Number

* REFUND POLICY 10% admin fee up until 14 days prior to start of program. 20% admin fee after 14 days prior to start of program. 35% admin fee once program has started. NO REFUNDS after 2 classes. MISSED CLASSES If a class is cancelled by Maccabi Canada due to unforeseen circumstances, Maccabi Canada will provide a makeup class at a date that both: coach and facilities are available. If a participant missed a class for any reason, NO MAKEUP CLASS will be provided.

I hereby release Maccabi Canada to use my/my child's photograph/video footage for marketing purposes.

* How did you hear about the program?

* RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT. BY SIGNING THIS AGREEMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS. PLEASE READ THIS DOCUMENT CAREFULLY I acknowledge and agree that in consideration of being permitted to participate in any Maccabi Canada Programs or Activities arranged, organized, sponsored, conducted, authorized, staged and/or operated by Maccabi Canada: 1. I HEREBY ACKNOWLEDGE AND AGREE THAT: • Maccabi Programs and Activities may be dangerous, exposing participants to many risks and hazards, some of which are inherent in their very nature, others which result from human error and/or negligence on the part of the persons involved in arranging, organizing, sponsoring, authorizing, conducting, staging and/or operating the Maccabi Programs and Activities; • The Maccabi Programs or Activities (including travelling to or from such Program or Activity) can be an extreme test of a person’s physical, emotional and mental limits and carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to: actions of other people including, participants, volunteers, spectators, coaches, event officials, event monitors and/or producers of the event; lack of hydration, weather, and/or other natural conditions. I hereby assume all of the risks of participating in any Maccabi Program or Activity; • I certify that I am physically, emotionally and mentally fit and have not been advised otherwise by a qualified medical professional; • I willingly agree to comply with the customary terms and conditions for participation. If however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest Maccabi Canada representative immediately; • I understand that neither Maccabi Canada nor any of its directors, officers, employees, volunteers, sponsors, independent contractors or agents assume any responsibility whatsoever for my safety during the course travelling to and from, or my preparation for or participation in any Maccabi Canada Program or Activity; • I understand that Maccabi Canada does not undertake to provide health, accident, disability, hospitalization, personal property, or other insurance for participants in our programs or activities. I affirm that I have appropriate medical insurance in the event medical attention is needed for me; • I understand that I may be photographed and agree to allow my photo, video, or film likeness to be used for any legitimate purpose by Maccabi Canada; • I hereby consent to receive emergency medical treatment that may be deemed advisable by a medical professional in the event of injury, accident, and/or illness during any Maccabi Program or Activity; • I nevertheless freely and voluntarily assume all the aforesaid risks and hazards, and that, accordingly, including traveling to and from, my preparation for, and participation in any Maccabi Programs and Activities shall be entirely at my own risk; 2. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby to the greatest extent permitted by law, RELEASE, HOLD HARMLESS AND INDEMNIFY Maccabi Canada and its directors, officers, employees, volunteers, sponsors, independent contractors and agents (collectively “the Released Parties”) from all liability, and all recourses, proceedings, claims, and causes of action of any kind whatsoever, present or in the future, in respect of any and all personal injuries or property losses which I may suffer arising out of or connected with travelling to and from or my preparation for, or participation in Maccabi Canada Programs or Activities notwithstanding that such injuries or losses may have been caused solely or partly by the active or passive negligence or breach of duty of Maccabi Canada or any of their directors, officers, employees, volunteers, sponsors, independent contractors or agents. I also recognize and agree that the Released Parties assume no responsibility for any liability, damage, or injury that I might sustain due to the intentional, unintentional or negligent acts or omissions of any other person or organization. 3. Governing Law This Agreement shall be construed, interpreted and enforced in accordance with the laws of the Province of Ontario, Canada. 4. Severability If any provision of this Agreement or its application to any Party or circumstance is determined by a court of competent jurisdiction to be illegal, invalid or unenforceable, it will be ineffective only to the extent of its illegality, invalidity or unenforceability without affecting the validity or the enforceability of the remaining provisions of this Agreement and without affecting its application to other parties or circumstances. 5. Acknowledgement of Understanding I have read this Release Waiver of Liability, Assumption of Risk, and Indemnity Agreement, and fully understand its terms and conditions. This is to certify that I as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releases from any and all liabilities incident to my minor child’s involvement or participation in these programs or activities.

Please list any allergies or medical conditions your child has and that we should be aware of

* BY REGISTERING YOUR CHILD TO OUR PROGRAM YOU AGREE THAT THAT: PARENT CODE OF CONDUCT • You will inform the coach of any physical disability or ailment that may affect the safety of your child or the safety of others. • You will learn and adhere to the policies of Maccabi Canada. • You will be a positive role model for your child and encourage sportsmanship by showing respect and courtesy, and by demonstrating positive support for all players, coaches, officials, staff, and spectators at every game, practice or other Maccabi Canada event. • You will not engage in any kind of disrespectful or unsportsmanlike conduct with any official, coach, player, medical or any other Maccabi Canada staff member, such as booing and taunting; or using profane language or gestures. • You will respect Maccabi Canada’s staff and their authority during practices and games and will never question or confront the Maccabi Canada leadership including officials, coaches, managers, medical team or liaisons. • You will refrain from coaching your child or other players during practices and games. • You will demand a sports environment for your child that is free from drugs, tobacco, and alcohol and you will refrain from their use at all sports events. • You also agree that if you fail to abide by the aforementioned rules and guidelines, you will be subject to disciplinary action that could include removal of your child from Maccabi Canada’s program at your expense and with no refund. Maccabi Canada reserves the right to release a child from any of its programs due to inappropriate behaviour of the child and/or their legal guardian.

I was referred by:

I referred this participant: