Canada`s Capital Short Track Ability Meet

The Gloucester Concordes Speed Skating Club invites you to:
Eastern Regional Ability Meet # 3
ENTRY FORM/FEUILLE D’INSCRIPTION
Sanctioned by O.S.S.A.
November 29-30,2008
Bob MacQuarrie Complex Orleans, Ontario
Please Print – All information must be completed
Last Name __________________________ Given Name________________________
Street ________________________________________ City ____________________
Province ___________________________ Postal Code ______________________
Telephone Number ___________________________ Club________________________
Head Coach
______________________________
Age Class Category __________________________ Male _______ Female ______
S.S.C. Number __________________________ Birth Date (mm/dd/yy)____________
Health Card Number (optional) _________________________
Seed Time
Tech Bulletin #25, Section A Regional Events states that there will be 3 groupings for setting up the ability
meet - Masters, Senior Category (JUV, JR, INT, SR age groups), and Junior Category (PW, MID, BANT age
groups). Senior Category skaters will be seeded on their 500m time, Junior category skaters will be seeded on
their 333m time. A skater will not skate without submitting a seedtime based on their Regional Event
Category.
Masters and Senior Category - 500m distance
Junior Category - 333m distance
________________
________________
NAME AND DATE OF COMPETITION AT WHICH SEED TIME WAS SET
NAME
DATE
BIRTH DATES ARE MANDATORY
Skaters will not be registered if this info is not submitted
In consideration of my accepting this entry, I hereby, for myself, my heirs, executors, administrators and
assigns, waive and release any and all rights and claims for damages I may have against SSC, OSSA, the
Gloucester Concordes Speed Skating Club, their agents, officers, or members for any and all injuries suffered
by me at said competition to be held on November 29-30,2008 at Ottawa, Ontario.
Considérant l’éventualité de l’acceptation de ma demande, je renonce par la présente, pour moi-même, mes
héritiers, exécuteurs testamentaires et administrateurs, à tous les droits et toutes les réclamations pour
dommages subis contre l’ACPVA, l’OSSA, The Gloucester Concordes Speed Skating Club,leur agents, cadres
ou membres, pour toute blessure dont je pourrais être victime lors de la compétition qui aura lieu le(s) 29-30
novembre,2008 á Ottawa, Ontario.
Signature of / du participant:
Signature of / du Parent or Guardian / ou tuteur (if / si participant is under 18 / à moins de 18 ans)
____________________________________________
In witness whereof, I have here unto set my and seal this _________ day of ___________________ 2008
En foi de quoi, j’ai appose ma signature et mon sceau en ce ________ jour de _________________ 2008
Sanctioned by OSSA
Sanction de OSSA
Location:
Bob MacQuarrie Recreation Complex
1490 Youville Drive,
Ottawa ON
Endroit:
Bob MacQuarrie Recreation Complex
1490 Youville Drive,
Ottawa ON
Hotel: CHIMO Hotel
1199 Joseph Cyr Street, Ottawa
613-744-1060
1-800-387-9779
Contact: Nathalie Edwards
Rate $109.00 + tax
Hotel: CHIMO Hotel
1199 Joseph Cyr Street, Ottawa
613-744-1060
1-800-387-9779
Contact: Nathalie Edwards
Rate $109.00 + tax
Check in: Friday, November 28
8:00-8:30
CHIMO Hotel
Enregistrement: vendredi le 28 novembre
20h-20 :30h
l’hotel CHIMO
Coaches Meeting:
8:30 PM
Cabot Room CHIMO Hotel
Rencontre des entraîneurs:
20:30h
Chambre Cabot l’hotel CHIMO
Warm Up: 8:00 AM
Réchauffement: 0800h
Entry Fee: $ 50.00 per skater. Family rate
$125.00 (3 or more skaters) Club cheque
only - payable to Gloucester Concordes
Frais d’enregistrement: $ 50.00 par patineur,
Un chèque par club, payable au nom de:
Gloucester Concordes
Club Registration Deadline: In our
possession, Wednesday, November 19 by
22:00. Late entries will not be accepted. Club
must register on the OSSA Club Registration
form.
Date limite d’enregistrement: Dans notre
possession, mecredi le 19 novembre. Auccun
enregistrement ne sera accepté après la date
limite. Les Clubs doivent s’enregister sur la forme
official de OSSA.
Entries e-mailed to: [email protected]
Phoned to: Susan Cook (613)-240-7498
Phoned entries must be guaranteed.
Enregistrement courriel: [email protected]
Par téléphone: Susan Cook (613) 240-7498
Les inscriptions par téléphone doivent être
guarentis.