1. Pickering Rouge Canoe Club’s 2014 Flatwater Registration Club Program Additional details regarding each program are on the website (www.pickeringrouge.ca) Program Dates Club Registration Fee (HST included) Volunteer Cheque (hours) U13 + U15 (Bantam) - program is designed for youth looking to learn the basics of sprint canoeing and have the chance to race at local and regional regattas in both singles and crew boats. April 28 th - June 27 th Mon- Wed 4 – 6, Sat 9 July 1 st - Aug. 29 rd Mon – Fri 9am- 1:00pm $635 $100 (10hrs) Development - U17 + U19 + U21 – for individuals that wish to race competitively at regional and provincial regattas. April 28 th - Sept. 1 st Mon- Thru 4 – 6 Tues & Thurs 6:15am $645 $100 (10hr) High Performance – This program is designed for paddlers who have shown commitment to the sport and aspire to race provincially as well as nationally. April 28 th - Sept. 1 st Weekly Timetable will be distributed to paddlers. $845 $150 (15 hrs) Adult Learn to Paddle (25+) - This program welcomes individuals new to the sport who would like to learn the basics of paddling. Providing a relaxed environment to make friends and enjoy time on the water! May 26 th - Aug. 19 th Mon & Wed. 6:15pm – 7:30pm $345 $100 (10 hrs) Masters (25+) - Flatwater specific program that teaches the fundamentals of canoe & kayak while preparing participants to compete at all levels of racing! May 5 th - Aug. 29 th Mon & Wed. 6:15pm – 7:30pm $345 $100 (10 hrs) Office use Only: Amount Received ___________________  Cheque Date___________________ 2013 Minimum Volunteer Hours Cheque  Received  Returned Date __________________ 2013 Entered in database Mailing Information: PRCC 91 Rylander Blvd, Unit 7, Box 187 Scarborough, Ontario, M1B 5M5 Or forms can be dropped off in our mailbox inside the West Rouge Community Center www.pickeringrouge.ca PAYMENTS CAN BE MADE BY CASH OR CHEQUE ONLY. PLEASE MAKE CHEQUES PAYABLE TO THE PICKERING ROUGE CANOE CLUB. Last NameFirst NameAge AddressCity/TownPostal Code Telephone (Home)Telephone (Cell / Other) Email AddressBirthday: M D Y _ _ / _ _ / _ _ _ _ Emergency Contact Info Name: Relationship to Paddler: Telephone: Health Card # _________

2. I hereby apply for membership in the Pickering Rouge Canoe Club and agree to obey all Club rules as posted. ____________________________________ ___________________________________ Applicant’s Signature Date In consideration of acceptance, I ______________________________ for myself and on behalf of my child and for my heirs, executors, administrators, successors and assigns hereby release, waive and forever discharge the Pickering Rouge Canoe Club (hereinafter called “PRCC”), its directors, club officials, volunteers, members, organizers, employees, coaches, sponsors, and administrators (hereinafter called the “Release”) of and from all claims, liabilities, demands, damage costs, expenses, actions, and causes of actions, whether in law or in equity, of every kind of nature whatsoever, in respect of death, injury, loss or damage to any person property, howsoever caused including but not limited to the negligence of any of the Releases, arising out of or in any way related to or connected with my or my child’s participation in practices, competitions, training camps or any other activities of the PRCC, or any travel incidental thereto. I warrant that I/my child am/is physically and mentally fit to participate in the practices, competitions, training camps, or any other activities of the PRCC and that I/my child is an able swimmer. I understand that canoeing is a dangerous activity that exposes participants to many hazards and risks, which I accept as a condition of my/my child’s membership in the PRCC. I hereby acknowledge having read, understood and agree to accept the terms and conditions of this Release. ____________________________________ *Applicant’s/Parent’s Signature Date I give permission for my/my child’s picture to be used by the Club for promotional activities. ____________________________________ *Applicant’s/Parent’s Signature Date (*Parent or guardian to sign on behalf of child if under the age of 18 years)  IMPORTANT – VOLUNTEER OPTIONS  PRCC is run by volunteers. All members (families and friends who volunteer count towards a members volunteer hours) are expected to assist in the operations of the club. By everyone contributing time we ensure that our club will continue to offer members some great benefits. The topics listed are areas where volunteers are needed at various times throughout the season. Your assistance will be greatly appreciated. For students, volunteer hours can go towards their high school community service hours. Your volunteer cheque (post-dated to October 1, 2012) will be kept on file and cashed in October, should you not provide the minimum hours volunteer time to the Club during the 2012 season. The cheque will be destroyed upon completion of minimum hours donated. If you do not wish to volunteer you can pay your volunteer fee at date of registration. Please see the attached sheet for detailed descriptions in the following areas: - Fundraising - Promotions/Special events - Building maintenance - Site maintenance - Equipment repair - Assist at paddle nights/clinics - Pickering Dragon Boat Festival - Junior Dragon Boat Challenge - Flatwater Regattas - Other_________________________________ I do not wish to volunteer  ALL REGATTA FEES AND SCRATCH FEES ARE THE RESPONSIBILITY OF EACH PADDLER. Fees must be paid to the Club Treasurer prior to the regatta. Membership Confirmation: All memberships are non-transferable. All refunds will be subject to a $35.00 administration fee plus HST. A full refund will be granted within 7 days of purchasing a membership with an e-mailed request and an administration fee will not apply. All other refunds are less a prorated amount for the number of days the membership was active. Memberships are active from the date of purchase. They become non-active at the end of the season or upon our receipt of your application for refund. Any refund will take approximately 2 – 4 weeks. Non-use will not be considered a reason for a refund of membership. Refunds will only be considered for medical reasons with proper medical documentation. Pickering Rouge Canoe Club reserves the right to change schedules, coaches or practices as needed without compensation or notice.