2013 BC PROVINCIAL POWERCHAIR FOOTBALL TOURNAMENT DEADLINE: May 1st, 2013 (Must be completed by all persons attending)

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1 2013 BC PROVINCIAL POWERCHAIR FOOTBALL TOURNAMENT (Must be completed by all persons attending) April 1, 2013 Dear Athletes, Coaches and Officials The following is the registration information for the Provincial Powerchair Football tournament, hosted by SportAbility & Kamloops Legacy Performance Games. You will find tournament, meals and hotel information in this package. All participants, (athletes, coaches, managers, sport assistants and referees, scorers and linesman) must fill out the registration form and read and sign the liability and publicity release form (pages 5 and 6). Coaches are asked to fill out the team roster forms (pages 7 and 8). Athlete s registration fee is $ this includes banquet, competition and Lunch s Coach s registration Fee is $30.00 this includes meals Sport Assistant Registration fee is $ This includes meals & banquet Officials- No Registration Fee- this is supplied by Kamloops Legacy Performance Games A confirmation package with a detailed schedule of events will be sent to the coaches and officials once all registrations have been received. Portable Hoyer Lift: If you are travelling with your portable Hoyer lift, Sportability is looking for an individual to bring their Hoyer lift to the facility during the tournament, if you are available to help please contact Jennifer at Anyone interested in volunteering for score keeping & linesmen please fill out the non-athlete for below. Can each Team provide one or two volunteers during this tournament. All participants must be members in good standing with SportAbility. Membership information can be found on the website at If you have any questions, please feel free to contact me, either by , SportDev@sportabiltybc.ca or phone, Thanks Jennifer Achterholt Sports Development Coordinator SportAbility Powerchair football

2 Personal Information: INDIVIDUAL REGISTRATION FORM Please Complete and Return to Sportability 6235C 136 Street, Surrey, BC, V3X 1H3 ***No late registrations accepted*** Role: Athlete Official Sports Assistant Coach Manager Other Name: Address: (Legal Name) City: Phone Number: Postal Code: Date of Birth: Dietary requirements: Emergency Contact: (mm/dd/yyyy) Sport: Team Name Phone: Name of Coach: Contact # Division: Division 1, Division 2, unknown Classification: PF 1 x PF2 Registration Fee: Athlete s Registration Fee: $70.00 total Athlete s Lunch & Banquet- Provided by Kamloops Legacy Performance Games Officials Registration fee: FREE Coach s Registration Fee: $30.00 (Includes Meals &banquet) Sport Assistance registration Fee: $30.00 ( Includes Meals) Optional REGISTRATION DEADLINE: MAY 1 ST, 2013 **** No registration forms will be accepted as all schedules, meal orders etc. Will be completed on May 1st, Please Registration and Mail Cheques to: SportAbility 6235C 136 Street Surrey, BC V3X 1H3 SportDev@Sportabiltybc.ca Please make cheques payable to SportAbility BANQUET Saturday June 15 th, 2013 Provided by Kamloops Legacy Performance Games Location & Time - TBA

3 TOURNAMENT INFORMATION MEMBERSHIP: All participants must be a current member of Sportability to participate in the games Current Member of Sportability: Yes No If no please fill out the attached membership form along with you registration forms. Or simply go to to complete a Membership form through Pay Pal. The membership fee is $ Fees for Event membership is $5.00 DATES: June 15 th, &16 th, :00am-5:00pm (Saturday and Sunday) WHERE: Tournament Capital Centre (TCC) 910 McGill Road Kamloops, BC, V2C 6N6 Ph: (general inquiries) ACCOMODATIONS: There will be a block of rooms booked at the Best westerns plus Kamloops hotel. Please call the Hotel s directly to Book your rooms and availability no later than May 27 th, All athlete s Hotel: Best Western plus Kamloops Hotel 660 Columbia Street West Kamloops, BC V2C 1L1 PH: Group Booking Name: Power Soccer Provincials 37 Rooms Blocked of for this tournament, please ensure you called before May 27 th, Rate: $ per night- Includes Breakfast Hospital Bed Rental/ Lift Rental: Medi Chair Guy Erbin (Service Manager) Tel: All booking need to be completed well in advance to receive this service. *** Please sent Sportability all medical equipment invoices **** Officials & individuals who require a Hospital Bed -Hotel booking (Only for individuals who require a hospital Bed): Group Booking Name: SportAbility 9 Rooms Blocked off Rate: $ per night includes breakfast Cutoff date for blocked rooms: May 27 th, *** Please sent Sportability all medical equipment invoices ****

4 LIABILITY AND PUBLICTY RELEASE BC PROVINCIAL POWERCHAIR FOOTBALL TOURNAMENT (Must be completed by all persons and returned by May 1 st, 2013) I, the applicant, on behalf of myself, members of my family, my heirs, executors, administrators, and assigns, hereby release, discharge, and hold harmless Sportability or Kamloops Legacy Performance Games of British Columbia, its staff, volunteers, representatives and agents (hereafter known as The Organizers) for any injury, loss, or damage to my person or property howsoever caused, arising out of or in connection with my participation in Sportability s 2013 BC Provincial Championships/Kamloops Legacy Performance Games and activities not withstanding that the same may have been contributed to or occasioned by the negligence of the organizers. I, the applicant, hereby consent, in case of accident from my participation in in SportAbility s 2013 BC Provincial Championships/Kamloops Legacy Performance Games, to medical assistance being administered on my behalf. Name of Participant Signature of Participant Signature of Parent/Legal Guardian, if under 19 years of age Date I, the applicant, hereby grant permission to Sportability or Kamloops Legacy Performance Games, and to any persons designated by them to use, display, and publish any photographic or recorded material from the SportAbility s 2013 BC Provincial Championships/Kamloops Legacy Performance Games Signature of Participant Signature of Parent/Legal Guardian, if under 19 years of age

5 TEAM ROSTER FORM Deadline: May 1st, 2013 TEAM NAME: Team Jersey color: Athletes (please print clearly) Players # Office use Non-Athlete team members (please print clearly) Role (Coach, support, family, score keeping, linesmen etc.) $30 Registration fee ( meals & Banquet