2020/2021 Participant Registration
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Full name *
Phone number *
Email *
Full mailing address *
Date of Birth *
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DD
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Emergency contact person *
Emergency contact phone number *
Do you have any health issues we should be aware of? (asthma, allergies etc) *
If yes, please specify
Do you have a disability? *
If yes, please provide description of disability
Participant type *
Payment option *
I give permission to have my personal information shared with BC Wheelchair Sports Association, BC Wheelchair Basketball Society, SportAbility, Engage Sport North & Spinal Cord Injury BC for the purpose of registering my membership with each organisation. *
Required
I give permission for use of my name and/or photograph/image in connection with Northern Adapted Sports Association publications, website & other promotional materials. *
Required
TERMS: By completing this Participant Registration form with Northern Adapted Sports Association, I am confirming that I understand the risks inherent in adapted sport, these risks arising from engaging in various sports that include contact and that are played in a variety of conditions with a variety of other persons of different levels of skill, and I agree to take responsibility for these risks and my safety. I further agree to release the Northern Adapted Sports Association and all its members, directors, and affiliates from any duty of care and I waive my right to sue the Northern Adapted Sports Association, its directors, members or its affiliates.  All Northern Adapted Sports Association program participants will be deemed members of the society. *
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