2019/20 Varsity Tryout Registration Form

Varsity Athlete Registration
All first year and returning athletes are required to fill out an online 2019-2020 Varsity Athlete Registration Form. This form is mandatory for any athlete interested in attending a tryout for a varsity sport and must be completed in advance of the first tryout. For any questions, please contact Jeff Harris at jeff.harris@georgiancollege.ca

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GENERAL

First Name *

Last Name *

Georgian College Student Number *

Lakehead University Student Number (if applicable):

Only fill this out if you are in an integrated Lakehead program @ Georgian

Are you an international student? *

Yes No

Email address *

Home Address (#, Street Name) *

City *

Postal Code

Address While Attending Georgian? *

Same As Above Georgian College Barrie Campus Residence Georgian College Orillia Campus Residence Georgian Green Varsity Properties Other

If other please list address (#, Street Name, City)

Cell Phone Number *

Date of Birth (DD/MM/YY) *

Citizenship *

Hometown (for roster)

Height

EMERGENCY CONTACT INFORMATION

Emergency Contact Name *

Relationship *

Phone Number *

ACADEMIC INFORMATION

Program of Study *

Year in Program

1 2 3 4 5

Will you be on a co-op this academic year? *

Fall Winter Summer No co-op

Which 2019-20 semesters will you be registered as a full-time student or on co-op (tick all that apply) *

Fall 2019 Winter 2020 Summer 2020

Anticipated year of graduation *

ex. Winter 2021, Fall 2022

High School attended *

High School year graduated *

ATHLETIC INFORMATION

Georgian Varsity Experience *

This is my first year I have played one year I have played two years I have played three years I have played four+ years

Have you ever played varsity sports at another college or university? *

You must identify any post-secondary institutions (other than Georgian) in which you attended and played on a varsity team (eg. OUA, U Sports, OCAA, NCAA)

Yes No

If yes, which institution

How many years of varsity sports have you played at other post-secondary institutions

0 1 2 3 4

Have you ever played professionally *

Yes No

I HAVE READ, UNDERSTOOD, AND ACCEPT THE FOLLOWING FORMS AND WAIVERS:

Travel Waiver *

I Accept I Decline

Participation *

I Accept I Decline

Declaration *

I Accept I Decline

TRAVEL

I understand that traveling with the Georgian College Athletic Program involves certain risks and dangers, which are inherent to transportation.

I recognize the risks inherent in travel and accept these risks freely, hereby releasing Georgian College and all its agents and employees for any loss, damage, injury or expense suffered by me in connection with all activities associated within the scope of traveling with the Georgian College Athletic Program.

In consideration of being permitted to travel with the Georgian College Athletic Program, I hereby release and forever discharge from any claim and liabilities whatsoever without limitation I might have against Georgian College in any of the activities I am involved in, and make this release on behalf of my heirs, executors, administrators or assigns.

PARTICIPATION

I understand that participation in the Georgian College Athletic Program involves certain risks and dangers, which are inherent to sport while training or competing at any level.

I recognize the risks inherent in athletic preparation and competition and accept those risks freely, hereby releasing Georgian College Athletic Program and all its agents and employees, the Ontario Colleges Athletic Association (OCAA) and the Canadian Colleges Athletic Association (CCAA), from any responsibility associated with that risk.

In consideration of being permitted to compete in the Georgian College Athletic Program, I hereby release and forever discharge from any claim and liabilities whatsoever without limitation I might have against the Georgian College Athletic Program, the OCAA and the CCAA in any of the activities I am involved in, and make this release on behalf of my heirs, executors, administrators or assigns.

DECLARATION

Collection and Use of Personal Information: I hereby, give consent to Georgian College to utilize information gathered from my academic record and my student file soley for the purpose of assessing my academic progress and intercollegiate athletic eligibility. I further acknowledge that any information gathered may be used for statistical purposes.

Applicants Declaration: I have given complete and true information. I have considered, understood and agree to the policies and procedures of the Student Athlete Manual (available online). I also agree that the Athletics Department may release my name and sports photos/videos to the media or use them in various promotional publications, including the display of such on website applications for the OCAA, CCAA, and on campus.

* required field