VARSITY TRYOUT REGISTRATION FORM 2022-23 - George Brown College Athletics

All students intending on trying out for a varsity sports team for the 2022-23 season must pre-register by filling out the following registration form.

**Students will not be permitted to enter the tryout without completing the registration form.**

Email address *

First name *

Last name *

Cell Phone Number *

George Brown College Student ID Number *

Health Card Number *

Emergency Contact Name:: *

Emergency Contact Phone Number: *

Which varsity sport would you like to tryout for? *

For Esports League of Legends only:

Please provide us with your Summoner name:

Have you had any known medical conditions? *

If yes, please provide a brief explanation: (Such as Asthma, Heart Murmur, Heart Disease, Diabetes, Epilepsy)

Are you taking any medication or supplements? *

If yes, which ones?

Do you have any allergies to any medications? *

If yes, which ones?

Do you have any allergies requiring immediate medical intervention (e.g. food, insect bites/stings, drug or environment). *

If yes, please explain?

How many concussions have you had in the past? *

What date was your last concussion?

WAIVER FOR PROSPECTIVE STUDENT-ATHLETES

WARNING: READ CAREFULLY! THIS AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS

I understand that participation in the George Brown College Varsity Athletic Program for the 2022-23 academic year (ie. August 15, 2022 to August 14, 2023) involves certain risks and dangers which are inherent to sport while training or competing and include but are not limited to death, serious neck and spinal injuries, head or eye injuries, serious injuries to virtually all bones, joints, ligaments, muscles, tendons and other aspects of the muscular-skeletal system, and serious injuries or impairment to other aspects of my body, general health and well-being. The preceding list is not inclusive and is meant solely to emphasize the level of risk and danger inherent in sport at any level of competition. I recognize the risk inherent in the game and hereby release George Brown College, its Board of Governors, Officers, Servants and Agents (“George Brown College”) and/or other institution (s) competing in the event, its Board of Governors, Officers, Servants and Agents (“College”), the Ontario College Athletic Association (OCAA), and the Canadian Colleges Athletic Association (CCAA) from any liability whatsoever arising out of or in connection with the Varsity Athletic Program, including any liability due to the negligence or breach of contract in the course of my participation or involvement in the Varsity Athletic Program. I further acknowledge that I have read the above release and understand that I am relinquishing any and all rights that I, or any of my dependents, or my heirs, executors or administration might have against George Brown College and the OCAA for any loss, damage, injury or expense suffered by me in connection with this activity associated with my participation in the George Brown College Varsity Athletic Program. In consideration of being permitted to compete in the George Brown College Varsity Athletic Program, I hereby release and forever discharge from any claim and liabilities whatsoever without limitation I might have against the George Brown College and the OCAA in any of the activities in which I am involved, and make this release on behalf of myself, and on behalf of my heirs, executors, administrators and assigns. I agree that pictures or videos taken of me while involved in this event may be used in promotions/displays and publicity-related multi-media productions. I further confirm that I am over the age of majority.

I CONFIRM THAT I HAVE HAD SUFFICIENT TIME TO READ THIS AGREEMENT IN ITS ENTIRETY, INCLUDING ALL OF ITS TERMS, THAT I FULLY UNDERSTAND ITS TERMS, AND I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL LEGAL RIGHTS BY SIGNING IT AND HAVE AGREED TO THE TERMS FREELY AND VOLUNTARILY. I UNDERSTAND THAT THIS AGREEMENT IS BINDING ON ME, MY HEIRS AND EXECUTORS.

I HEREBY ACKNOWLEDGE THAT BY TYPING MY NAME IN THE BOX BELOW I AM CONSENTING TO ALL PROVISIONS IN THIS AGREEMENT AND THAT MY TYPED NAME CONSTITUTES A VALID AND BINDING SIGNATURE.

Name of Participant: *

Signature (Typed): *

* required field