CCSPO 2013 CSLCs - Registration / Inscription

2013 CANADIAN SURF LIFESAVING CHAMPIONSHIPS
Registration Package
DATE
August 23-25, 2013
LOCATION
Martinique Beach and Rainbow Haven Beach, Halifax County, Nova Scotia
COMPETITION
The competition is sanctioned by the Lifesaving Society Canada. International Life Saving
Federation Manual rules (2011 edition) and the 2012 Canadian Competition Manual will
be followed.
ENTRY DEADLINE
Registration and complete entries must be received by August 16, 2013. No late entries
will be accepted. Registration and entries are considered complete when all of the
following have been received at 400 Consumers Road.
 Team registration form completed in full
 Payment in full
 Waiver and Release form – completed and signed by all competitors, coach and
manager
 Each competitor’s Registered Athlete number with a copy of current Lifesaving
Society Award or a copy of each competitor’s current Lifesaving Society award,
proof of age and proof of Canadian citizenship.
ENTRY FEES
Option 1
All inclusive
Option 2
Option 3
REGISTRATION
$110.00 (includes competitor registration into all events, banquet
ticket, and competition shirt) per person
$90.00 (includes competitor registration fees into all events, banquet
ticket) per person
$50.00 (includes competitor registration into all events) per person
Send registration form with payment in full – cheque (payable to the Lifesaving Society),
Money Order, VISA, MasterCard, or AMEX – to:
Lifesaving Society
Phone: 416-490-8844 Fax: 416-490-8766
Attention: Wendy Mahony
Email: [email protected]
400 Consumers Road, Toronto, On M2J 1P8
ACCOMODATIONS
Booking Procedure: Call or e-mail the hotel directly and ask to book rooms under the
Canadian Surf Lifesaving Championship block. The rate of $99.99 and the block of
rooms will be available until August 1st, 2013. Thirty minutes to Martinique Beach.
Twenty minutes to Rainbow Haven Beach.
Information: The Quality Inn Halifax/Dartmouth has free continental breakfast every
morning. A large Superstore grocery outlet in adjacent to the hotel. Free Wireless internet
is available in all rooms. Some cots are available, but will be reserved on a first come, first
served basis. Web site: www.micmachotel.com
Phone: 902-469-5850 Email: [email protected]
Rate for CSLC is $99.99
Page 1 of 8
CHAMPIONNATS CANADIENS DE SAUVETAGE SUR PLAGE OCÉANIQUE 2013
Trousse d'inscription
DATE
23 au 25 Août, 2013
LIEU
Plage Martinique et Plage Rainbow Haven, Halifax, Nouvelle-Écosse
COMPETITION
La compétition est sanctionnée par la Société de Sauvetage du Canada. Les règles
internationales Life Saving Federation (édition 2011) et le Manuel de compétition
Canadien (2012) seront suivies.
INSCRIPTIONS
Les inscriptions doivent être reçus avant le 16 Août 2013. Aucune inscription sera acceptée
après cette date. L'inscription ne sera considérée comme complète lorsque toutes les
élements suivantes ont été reçus à 400 Consumers Road.
- L’inscription d’équipe dûment rempli
- Le paiement complet
- Renonciation - dûment rempli et signé par tous les concurrents, entraîneur et gérant(e)
- Numéro d’athlète pour chaque concurrent avec une copie de la certification de la Société
de sauvetage ou une copie de la certification de la Société de sauvetage de chaque
concurrent accompagnie par preuve d'âge et une preuve de citoyenneté canadienne.
FRAIS D'INSCRIPTION
Option 1
Tout compris
INSCRIPTION
HÉBERGEMENT
110,00 $ (incluant l'enregistrement de l’athlète dans toutes les
épreuves, billet pour le banquet, et la chemise des champioannats)
par personne
Option 2
$ 90,00 (incluant l'enregistrement de l’athlète dans toutes les
épreuves, billet pour le banquet) par personne
Option 3
$ 50,00 (incluant l'enregistrement de l’athlète dans toutes les
épreuves) par personne
Envoyer le formulaire d'inscription avec paiement complet par chèque (payable à la
Société de sauvetage), mandate postal, VISA, MasterCard ou AMEX - à:
Société de sauvetage
Téléphone: 416-490-8844 Télécopieur: 416-490-8766
Attention: Wendy Mahony
Courriel: [email protected]
400 Consumers Road, Toronto, ON M2J 1P8
Procédure de réservation: Appelez ou envoyez un email à l'hôtel directement et demander à
réserver des chambres dans le cadre du bloc due championnat de sauvetage en plage
océanique canadien (Canadian Surf Lifesaving Championships). Le taux de 99,99 $ et le
bloc de chambres sera disponible jusqu'au 1er Août 2013. Trente minutes à la plage
Martinique. Vingt minutes Rainbow Haven Beach.
Information: Le Quality Inn Halifax / Dartmouth offre un petit déjeuner continental gratuit
tous les matins. Un grand magasin d'épicerie hypermarché à côté de l'hôtel. Internet sans fil
gratuit est disponible dans toutes les chambres. Certains lits sont disponibles, mais seront
réservées sur un premier arrivé, premier servi venir.
www.micmachotel.com Téléphone: 902-469-5850
Email: [email protected]
Tarif CSLC est de 99,99$
Page 2 of 8
Schedule of Events(subject to change)
Horaire des épreuves (sous réserve de changements)
Thursday, Aug. 22 / Jeudi 22 Août, 2013
1900 hrs – 2100 hrs
Coaches Check In / Entraîneurs Arrivée
Micmac Hôtel Salle de conférence
Friday, Aug. 23 / Vendredi , 23 Août , 2013
Time / heure
0800
0830
0930
1230
1330
1400
Activity / activité
Captains / Coaches Briefing / Réunion des capitain(e)s / entraîneurs
Officials Briefing / Réunion des officiels techniques
Surf Ski Race (preliminaries and final) / Surf Ski (préliminaires et finale)
Surf Race (preliminaries and/or final) / Nage (éliminatoires et / ou finale)
Lunch / dîner
Opening Ceremonies / Cérémonies d'ouverture
Board Race (preliminaries and final) / Planche (préliminaires et finale)
Board Rescue (preliminaries and final) / Relais sauvetage planche (préliminaires et finale)
Location /
lieu
Martinique
Beach, NS
Saturday, Aug. 24 / Samedi, 24 Août, 2013
Time / heure
0800
0830
0900
1230
1330
Activity / activité
Captains / Coaches Briefing / Réunion des capitain(e)s / entraîneurs
Officials Briefing / Réunion des officiels techniques
Oceanman / Oceanwoman (preliminaries/final) / Combiné (préliminaires / finale)
Rescue Tube Rescue (preliminaries and final) / Relais bouée tube (préliminaires et finale)
Lunch / dîner
Oceanman/Oceanwoman Relay (preliminaries and/or final) / Relais Combiné relais
(préliminaires et / ou finale)
2 km Beach Run (final) / 2 km course (final)
Location /
lieu
Martinique
Beach, NS
Sunday, Aug. 25 / Dimanche, 25 Août, 2013
Time / heure
0800
0830
0900
0930
1300
1400
1900
Activity / activité
Park gates open / Portes du parc ouvertes
Captains / Coaches Briefing / Réunion des capitain(e)s / entraîneurs
Officials Briefing / Réunion des officiels techniques
Beach Sprint (preliminaries and final) / Sprint (préliminaires et finale)
Beach Flags (preliminaries and final) / Bâtons (préliminaires et finale)
Lunch / dîner
Beach Relay (preliminaries and final) / Relais sprint (préliminaires et finale)
Awards Buffet (Dinner Served at 1930hr) / Buffet (souper servi à 19h30)
Location /
lieu
Rainbow
Haven Beach,
NS
TBC
Page 3 of 8
Team Registration / Inscription de l’équipe
Team contact information / Coordonnées pour rejoindre l’équipe
Team/Équipe:
Club or Affiliate/Nom du Club ou Affilié:
Coach/Entraîneur or/ou Manager/Gérant
Mailing Address/Adresse postale:
Phone/Téléphone:
Fax/Télécopieur:
Email/Courriel:
City/Ville
Province
Postal Code/Code postal
Entries will be confirmed by e-mail / Votre inscription vous sera confirmée par courriel. Please print clearly Écrivez lisiblement s.v.p.
Registration Fees / Frais d’inscription
How many?
Combien?
Description
Price each/
Coût par équipe
All inclusive (includes competitor registration fees into all events; banquet ticket;
competition shirt). Complete shirt sizes below.
Line total/
Total de cette ligne
$110.00
Competitor registration (includes competitor registration into all events; banquet ticket)
$90.00
Competitor Registration fees into all events
$50.00
Extra Banquet Tickets
$40.00
2013 Canadian Surf Lifesaving shirt (please indicate sizes below)
Shirt du Championnats canadien de sauvetage (indiquez la pointure s.v.p.)
XL /
S/P
M
L/G
XG
$25.00
XXL /
XXG
Total
Payment/Paiement
Payment method/
Mode de paiement
Credit card number/
Numéro de la carte de crédit
Credit card holder/Nom du
titulaire de la carte de crédit
Signature of credit card holder/
Signature du titulaire de la carte
Phone/Email (if different than
above)/Téléphone/courriel (s’il
est différent de celui ci-dessus)
 Cheque/Chèque
 Money Order/Mandat postal
 VISA
 MasterCard
 AMEX
Expiry date/date d’expiration
Page 4 of 8
Open Competitor Registration
*All competitors must be registered prior to start of the competition. Competitors are considered registered when all documentation has been received and fees have
been paid. Competitors who are not registered may not compete. A Registered Athlete number is the preferred proof of eligibility. Competitors with a Registered
Athlete number need not provide any documentation. Event entries will be done on site.
Eligible documents
Canadian citizenship
Birth date
Lifesaving award
yes
yes
yes
no
no
yes
yes
yes if shown on card
yes
no
no
no
no
no
yes
Birth certificate
Passport
Health Card
Drivers Licence
Lifesaving Society certification card
Please print clearly and provide legible copies of documents.
Team
Last name
First name
Sex
Birthdate
YY
MM
DD
Email
Proof of eligibility*
OR
Reg Athlete No.
attached
Captain – Last name,
Captain – First name
Page 5 of 8
Masters Competitor Registration
*All competitors must be registered prior to start of the competition. Competitors are considered registered when all documentation has been received and fees have
been paid. Competitors who are not registered may not compete. A Registered Athlete number is the preferred proof of eligibility. Competitors with a Registered
Athlete number need not provide any documentation. Event entries will be done on site.
Eligible documents
Canadian citizenship
Birth date
Lifesaving award
yes
yes
yes
no
no
yes
yes
yes if shown on card
yes
no
no
no
no
no
yes
Birth certificate
Passport
Health Card
Drivers Licence
Lifesaving Society certification card
Please print clearly and provide legible copies of documents.
Team
Last name
First name
Sex
Birthdate
YY
MM
DD
Email
Proof of eligibility*
Reg Athlete No.
OR
attached
Captain – Last name,
Captain – First name
Use additional forms if necessary.
Page 6 of 8
16-19 year old Competitor Registration
*All competitors must be registered prior to start of the competition. Competitors are considered registered when all documentation has been received and fees have
been paid. Competitors who are not registered may not compete. A Registered Athlete number is the preferred proof of eligibility. Competitors with a Registered
Athlete number need not provide any documentation. Event entries will be done on site.
Eligible documents
Canadian citizenship
Birth date
Lifesaving award
yes
yes
yes
no
no
yes
yes
yes if shown on card
yes
no
no
no
no
no
yes
Birth certificate
Passport
Health Card
Drivers Licence
Lifesaving Society certification card
Please print clearly and provide legible copies of documents.
Team
Last name
First name
Sex
Birthdate
YY
MM
DD
Email
Proof of eligibility*
OR
Reg Athlete No.
attached
Captain – Last name,
Captain – First name
Page 7 of 8
Waiver and Release Form
Please read carefully before signing
Each competitor must sign this form with the entry form to be eligible to compete. Participants 18 years and under must
have the form signed by their parent or guardian.
1. Conduct
I agree to abide by the rules, regulations, and code of conduct of the championship, and further to behave in a manner
consistent with good sportsmanship.
2. Voluntary Assumption of Risk
As a competitor in a lifeguard competition, I recognize that there are certain risks inherent in the activity as a result of
factors including but not limited to, stress, number of people, water temperature and conditions. I have prepared myself
for the competition and know of no factor or condition which should be disclosed to the organizers or which would make
it unsafe for me to compete. I voluntarily assume all risks, both physical and legal including but not restricted to loss or
damage to property, and personal injury including permanent disability or death.
3. Waiver of Liability
As a condition of entry and in consideration of my application as an individual or as part of a team being accepted, I
hereby waive my right to make any claim, whether for negligence or otherwise against the Lifesaving Society, the host,
the owner or occupier, the sponsors, the organizing committee or any of the servants, agents, affiliates, volunteers, judges,
officials, or other persons involved in the organization of and the running of the competition, events or sanctioned
associated activities. I further agree to indemnify and hold harmless all of the above, from any claim made on my behalf
or as a result of injury to my person or property.
4. Model Release
I transfer to the Lifesaving Society all rights whatsoever which I have in photographs and/or videos that photographers
may have taken. I consent to the use of the photographs/videos for all purposes whatsoever, including without limitation,
television, publications, and any trade or advertising purposes.
I have carefully read and understand the four conditions of entry and in consideration for being allowed to compete, I
have executed them voluntarily intending to be bound thereby and intending these conditions to be binding of my heirs,
personal representative and assigns.
Print Name
Signature
Date
Coach
Manager
Captain
#2
#3
#4
#5
#6
#7
#8
#9
#10
#11
#12
Use additional forms if necessary.
Page 8 of 8