Little Rocks & Junior Curlers Application Form

Northumberland Community Curling Club

Curling Registration Form for Little Rocks and Juniors
Guidelines

for Little Rock Grades 4 – 6 (U13) and

Junior Curling Grades 7 - 12 U15 / U18
- Please carry your “curling shoes/clean sneakers" to the club. We cannot allow dirty shoes on the ice surface. NCCC requires all Little Rocks to wear 2 grippers on the ice. This is for safety and protection of the ice surface. NCCC has some Little Rock Grippers.
- You must wear a safety helmet securely on your head the entire time you are on the ice.
- Wear clothing that is warm and comfortable… jogging pants, hoodies… and don’t forget your mittens.
- Appropriate behavior is always expected. Running is not allowed either in the club or on the ice surface.
- If the weather is bad and curling is cancelled, you will be contacted via email several hours before start of class. Cancellation notices will also be posted on our Facebook page.
- If there are any parents or older siblings that would like to help out with the program please let us know.
Good Curling
Please select the age group of the applicant?*

Little Rocks - Grade 4 - 6 - U13Junior Curler - Grade 7 - 12 - U15 / U18
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Parent or Guardian's Email*
example@example.com
Person to Contact in Case of Emergency: Name & Phone Number*
Secondary Contact Person in Case of Emergency: Name & Phone Number
My child wears size shoe?*
My child delivers the stone with their...*

Right handLeft hand
MSI # *
MSI Expiry Date *

YearMonthDay
Date
Constent Form

1) I hereby grant authority to the Northumberland Community Curling Club or its' representatives to take or authorize any action intended to assist the curler named above in any emvergency and will not hold them responsible should an accident occur.
2) For advertising purposes, and for members information, NCCC will sometimes post activity pictures on our Club's website and/or Facebook page. We do not name any youth participants and strive to only take "action Photos" of larger groups for these purposes. As a parent or Guardian, do you give us permission to use an image with your child in the picture?*

YesNo
Date*

MonthDayYear
Date
Allergies / Medications / Medical Conditions...
Parent or Guardian Signature
Should be Empty:

Northumberland Community Curling Club

Constent Form