Register for Camp 2024: Camp Registration What is your first name? * And your last name? * Are you registering yourself or someone else? * Choose an answer ...MyselfSomeone else What is the camper's first name? * ...and their last name? * Which camp are you registering for? * Choose a camp...August 9-11, 2024 (U12)Camp 1 - July 29 - August 2, 2024 (Adult/Junior 12+ Week 1) Which level of camp are you registering for? * Choose a level...DevelopmentAdvancedElite Pre-requisite * CCE Development Camp Equivalent To attend one of our advanced camps you must have completed either a CCE Development camp or an equivalent program/experience. If you have any questions regarding this please contact us BEFORE completing this form. What CCE Camp did the camper complete (year), or what equivalent program/experience did the camper participate in? * Pre-requisite * CCE Advanced Camp Equivalent Provincial/National Competition Experience To attend one of our elite camps you must have completed either a CCE Advanced camp or an equivalent program/experience. If you have any questions regarding this please contact us BEFORE completing this form. What CCE Camp did the camper complete (year), or what equivalent program/experience did the camper participate in? * What is the camper's date of birth? * What is the camper's home curling center? * Lunch will be provided for $88 (taxes incl.) for the week. Would you like to add this option? * Yes No Now we need some contact information for the camper. If you are registering yourself please provide your contact info here. If you are registering for someone else, like a child, please enter the information of the person who should be contacted regarding their camp registration. Please provide a contact email. * Enter your email address. Confirm Please provide a contact email. * Confirm your email address. ... And a contact phone number. * If you would like to add an alternate phone please do that here: (optional) In cases of emergency, who should we contact? (please provide their first AND last name) * Please provide the emergency contact's daytime phone number: * and now their evening phone number: * Please provide a second emergency contact in the case the first one is unable to be reached. * What is their daytime phone number? * and their evening phone number? * For emergency use please provide the camper's Medicare/Hospital/or Insurance number. * Is the camper on any medications? (if so please list them, if not answer "no".) * What about any allergies? (if yes, list them, if no answer "no".) * Has the camper had any previous injuries? (if yes, please explain. If no enter "no".) * Is there any other relevant medical information or conditions we should be aware of? (Simply enter "No" if not) * Next up we have a couple of waivers we need you to sign. We need you to read these in full and then provide your electronic signature either with your mouse, or by typing (click the keyboard icon to type) These signatures are considered binding and are exactly as if you had written your signature traditionally. Privacy Waiver Curl Moncton and the Centre of Curling Excellence respects and protects the privacy of our curlers, membership and guests. We will not release any mailing information or participant lists to any other organization, sponsors etc. Video and or Photographs may be taken throughout the camp. These may be used in promotional material for future activities and events for Curl Moncton and or the Centre of Curling Excellence. Please indicate below if you consent to the use of your or your child’s image on any promotional material for any of our future activities and events. I hereby, give consent to Curl Moncton & the Centre of Curling Excellence to use the image of my child or myself in any promotional materials (brochures, posters, etc. and on the website to assist with the promotion of the activities and events. Electronic Signature (Parent or Guardian Signature if participant is a minor) * signature keyboard Clear I have read and understand the privacy waiver. Waiver of Liability I knowingly and freely assume the inherent risks both known and unknown associated with this program, even if arising from the negligence of the curling club, program instructors or others, and assume full responsibility for my participation. This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above for myself and my child, I release Curl Moncton Inc., the program and instructors from any and all liabilities incident to my minor child’s involvement or participation in the programs as provided above, even if arising from the negligence of the releases. Electronic Signature (Parent or Guardian Signature if participant is a minor) * signature keyboard Clear I have read and understand the waiver of liability. How would you like to pay? * eTransfer Online Your transfer should be sent to: info@ccetraining.ca Your total is: Credit Card Information Name on Card Please enter your name exactly as it appears on your credit card. 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