2021 New Member Registration Form

NEW MEMBERS: Please fill out and submit this entire form and submit a Medical Release Form to operations@teamsurvivornw.org or fax it to: 206-732-0263. 

There is no cost to become a member. You will receive a membership card in the mail a couple of weeks after both items have been received.

To download a copy of the Medical Release Form, click HERE.

RETURNING MEMBERS: Please click here for a shorter form.

2021 MEMBERSHIP INFORMATION

Please note: Checking a box does not register you for the program, it helps us gage our members' interests to know what programs to strengthen. Registration is separate. During the pandemic, some of our programs cannot take place, but please check our website for updated information on classes and events.

Some questions allow us to collect general data to be sure our programs are reaching people from all backgrounds and from all locations/hospitals and that we support women with all types of cancer. We appreciate you sharing as much information as you feel comfortable. For some of these fields, we have listed "Prefer not to answer" as an option in case you do not want to include that information.

At Team Survivor Northwest, we value community. If you would like to be part of the TSNW Directory please click on the boxes of information you feel comfortable sharing (required fields are full name and e-mail). The information will ONLY be shared with other TSNW Members who have opted in to the directory.

If you would like to be in the directory, we encourage you to add your picture below (a headshot).

NOTE: While Team Survivor will do everything possible to keep this information available only for other TSNW Members, we cannot control what an individual may decide to share without our permission. By submitting your information, you acknowledge this risk and agree that you will not hold TSNW liable for information that another member may share.

I am aware that participation in fitness programs or events, including TSNW programs and events ("TSNW Activity"), involves certain risks, including but not limited to the risk of serious bodily or mental injury or death, and the risk of economic loss, arising out of my participation in a TSNW Activity and whether caused by me or by someone else, including TSNW, as defined below. I am aware that TSNW does not manufacture or guarantee the safety of the equipment that may be used during a TSNW activity.

In consideration of my participation in TSNW Activities, by my signature, I acknowledge and confirm that I have read and understood this membership form in its entirety and particularly for the following releases:

• I am physically able to undertake, and am voluntarily participating in, any TSNW Activity in which I choose to participate, with knowledge of the risks involved and I hereby accept full responsibility for these risks, which include the risk of economic loss.
• I voluntarily accept the risk of sustaining injuries arising from or during the participatio in a TSNW Activity, which may range from minor to catastrophic.
• On behalf of myself, my spouse (if any), my parents (if any), my children (if any) and any heirs or assigns, I release TSNW from any liability and/or claims for damages that may arise due to my participation in a TSNW Activity.
• To the extent that there is no conflict between my previous releases of TSNW's liability (if any), and the representations contained in this form, all previous releases shall continue to apply. In the event of a conflict, the releases contained in this form shall control.
• I know of no physical or medical reason or impairment that might prevent or hinder my participation in a TSNW Activity of my choosing, though I acknowledge the right of TSNW to refuse to allow me to participate in a TSNW Activity if deemed appropriate to preserve the safety and enjoyment of all participants in that activity. It is my responsibility to continually monitor my ability to participate in TSNW Activities.
• I understand that TSNW does not employ health-care professionals to implement and monitor TSNW Activities. Any discussion of health-related issues at a TSNW Activity shall not be deemed to create a duty in, nor put TSNW on notice of, a health or medical concern that requires TSNW to take any action or issue any warning to me regarding my participation in TSNW Activities or the advisability of consulting with a medical professional. TSNW cannot and will not advise me whether to participate or to refrain from participating in any activity based on my physical condition or health-related concerns.
• TSNW has not made and will not make in the future any representations to me regarding my physical condition or my ability to participate in TSNW activities.
• Any health or medical concerns that arise now or in the future will be reviewed, at my discretion, with my physician or other medical profesisonals outside of TSNW.

The ability to show our members participating in TSNW programs allow us to help more women benefit from our programs. Occassionally, we will have a photographer take photos and we appreciate your willingness to be photograghed. We never use names when sharing photos, unless we contact the individual first about a specific photo and ask persmission to share a name.

I hereby consent to the reproduction, publication and use of my likeness in any format for promotional purposes or for any other purpose consistent with TSNW's charitable mission, of photographs or videos (collectively, "Photos") of me by TSNW. I hereby release TSNW from any liability and/or claims for damages that may arise, now or in the future for the use of any Photos.

If you decide not to sign the consent and release photo use, we ask that you upload your picture so we are able to recognize you.

1.1 Introduction
TSNW is committed to a culture of respect, fairness, support and trust for our members, our instructors, coaches and program leaders, our staff, our board and our volunteers. Everyone is expected to act in alignment with these values.
Our members are at times dealing with physical and emotional challenges related to the effects of a cancer diagnosis and treatment. We expect our program leaders, coaches and instructors to do their best to make accommodations for everyone in their activity to encourage participation in any stage of treatment or recovery. It is our goal to provide an encouraging and supportive environment. However, some activities are more intensive than others and may not be suitable for everyone whether due to their stage of recovery or overall fitness level. In addition to getting a medical release, we also require our members to take into account their own capabilities and make good choices to protect their own safety and recovery. We provide many options and provide guidance on intensity level for our activities.
Group activities such as hiking and Dragon Boat paddling have their own set of guidelines and rules to protect the individual and the group. Each participant must follow the guidelines and rules as set forth by the leader(s) of the activity. Should the participant exhibit behavior that puts others or themselves at risk, they will be asked by the leader(s) to change their behavior and should the issue not be resolved immediately, they will be suspended from the activity and the board president notified. The activity leader and board president will meet with the participant to discuss options, which may result in the member being asked to find a different activity. The decision of the Board President will be final.

2.1 Dragon Boat Paddling
Dragon Boat paddling is a team sport that is coached by experienced, skilled volunteers. While the coaches and captains do everything they can to accommodate a range of skills and fitness levels, they are in charge of a team of women and must also take into account what is best for the team.
Paddlers are required to follow the team rules, guidelines and coaching instruction. No one should ever be expected to perform beyond what is safe for them, whether it is a particular drill or length of time on a practice exercise. Paddlers are free to pull their paddle out and sit quietly as the practice continues. Self-awareness is encouraged. Paddlers are also encouraged to make coaches aware of any limitations or injuries. However, as participants in a team sport, paddlers must be similarly respectful of other paddlers and teammates. They are expected to listen to the coaches’ feedback and to focus on their own paddling and technique. The coaches will do their best to accommodate individual paddler needs, but will also focus on the team as a whole when making decisions for benching, practices and races.
As SAKE members, the participants are also subject to the rules and code of conduct for club SAKE. Should any paddler fail to follow the rules or cause serious disruption to the safety or enjoyment of the activity for other paddlers, they will be cautioned and may be asked to not participate by the club and/or the TSNW Board President. The TSNW board should be notified if there are issues with TSNW member behavior. Should the disruption not rise to the level of SAKE involvement, or not be a safety issue, the coaches and captains may work with the member to provide guidance and feedback. At any time, the issues may be escalated to the board for a remedy. The coaches and captains must involve the board if they wish for the member to be removed from future participation in the activity.

2.2 Hiking
The mid-week hiking group requires that participants behave in a safe and respectful manner while hiking as part of a TSNW group. Each new participant will be provided with the mid-week hiking orientation document which includes the rules and requirements for mid-week hiking participation.
TSNW strives to meet the needs of all of the women within a group of fitness ranges, by allowing faster hikers to move more quickly as well as to ensure that slower hikers can proceed at a more moderate pace. That said, as a seasonal activity, the hikes at the beginning are shorter and less intensive than the hikes later in the season. Should any hiker fail to follow the rules or cause serious disruption to the safety or enjoyment of the activity for the other hikers, they will be cautioned first by the hike leader. Safety issues are always considered more urgent than disruption of other participants’ enjoyment and the leaders can and should take immediate action and notify the board that such event has occurred. Should the behavior create an unpleasant experience for other hikers but not be a safety issue, the hike leaders may caution the member and must involve the board if they wish for the participant to be removed for future participation in that activity.

2.3 All Activities
Although it is impossible to list all forms of unacceptable behavior, following are examples of infractions that may result in corrective or disciplinary action:
• Any form of dishonesty.
• The use of offensive, disrespectful or disparaging language directed at another member, competing team, instructor or the public.
• Inappropriate use of electronic communication that may harm or disrespect other members, leaders, staff or volunteers
• Theft, misuse or inappropriate removal of property.
• Falsification of records.
• Possession, use or distribution of alcohol or drugs except as explicitly allowed.
• Verbal or physical violence.
• Smoking in prohibited areas.
• Possession of firearms, weapons or other dangerous materials.
• Failure to comply with TSNW rules and policies.
• Failure to comply with the terms of any corrective or disciplinary action as imposed by the board.
• Sexual, unlawful or unwelcome harassment or discrimination (see 3.1for additional detail)

3.1 Harassment and Discrimination
A critical part of Team Survivor’s values and members’ experience is that of equity and respect for all individuals, regardless of gender, race, religious affiliation, sexual orientation, gender identity, ethnicity, language, physical or mental ability, age, and any other way in which we may differ from each other.
Those associated with Team Survivor NW should never tolerate inappropriate behavior. If feasible, a member or guest should first make his/her feelings known to the offending person, tell him/her that the behavior is not appropriate and request that the behavior stop. However, if a member or guest is uncomfortable in addressing the issue with the offending party, or if the behavior is judged to be pervasive or more severe, the member or guest must promptly report any offending behavior, whether such behavior is directed towards her personally or towards others associated with the organization. Reports of offending behavior must be made to the activity leader or a member of the board. The individual receiving the complaint will communicate it to the Board President. Team Survivor NW is committed to conducting a timely investigation of any harassment complaints and taking appropriate action based on the findings from the investigation. The organization prohibits retaliation against those who’ve raised complaints of harassment or assisted in the investigation of harassment complaints.

3.2 Complaints Regarding Other Infractions
Similar to the process for complaints relating to harassment, members are requested to submit any concerns regarding inappropriate behavior (such as those within the examples above) to the activity leader or a board member. The individual receiving the complaint will communicate it to the Board President.
Investigations of Complaints: Concerns relating to harassment or other inappropriate behavior shall be investigated in a timely, fair and confidential manner. The Board President shall conduct or lead the investigation or assign the investigation to another board member. Investigations will be conducted as discretely as is practical, understanding that complete confidentiality may not be possible in many cases. When the subject of a complaint is a member not serving as a board member, the findings and recommendations from the investigation will be presented to the board for a final decision/resolution by the board. If the subject of a complaint is a board member, the board will create an independent ethics committee to investigate the complaint. Their findings and conclusions shall serve as the final decision/resolution.

4.1 Corrective and Disciplinary Actions
If necessary, TSNW may apply a range of remedies in response to violations of policy. These may include:
• Probation—verbal or written warning for a specified period, during which the individual may participate in TSNW activities as defined within the terms of probation.
• Suspension—written warning for a specified period, during which the individual is not allowed to participate in any TSNW activities.
• Disqualification—permanent revocation of the individual’s eligibility for TSNW membership.

A link to the Code of Conduct is also posted to the TSNW website, on the Membership page. With this agreement, we hope to provide safe and inclusive programs for all of our members to enjoy. Please sign below to agree to the TSNW Code of Conduct. Thank you for being part of our team!