Membership Forms

SZ RACING CLUB

Membership & Medical Form

1^st October – 30^th September 2012

To ensure we have the correct contact details for you, please fill out this form and give it back to Helen Chapman, Welfare Officer. (Address on page 3).

If you are under 16, please also ask your parent or carer to sign the form before it is returned. We will also use this information to ensure that you are kept informed about club events.

Note: No racer will be allowed to practice or race with the team unless this form is returned to the Welfare Officer – Helen Chapman (address on page 3).

Name¹
Date of Birth				Gender:	Male	Female
(If under 18)	Day	Month	Year	Membership No:

Name²
Date of Birth				Gender:	Male	Female
(If under 18)	Day	Month	Year	Membership No:

Name³
Date of Birth				Gender:	Male	Female
(If under 18)	Day	Month	Year	Membership No:

Name⁴
Date of Birth				Gender:	Male	Female
(If under 18)	Day	Month	Year	Membership No:

Name⁵	SZ Racing Committee Member
Date of Birth				Gender:	Male	Female
(If under 18)	Day	Month	Year	Membership No:

Address

Post Code

Home Tel No

Mobile No*

Email*

Mother’s Name

Work Phone

Address/Home Phone (if different from above):

Father’s Name

Work Phone

Address/Home Phone (if different from above):

Emergency Contact

(other than parents)

Telephone No.

Race Insurance – Company Name:

Policy No:

Expiry Date:

* Neither the mobile number nor the email should be that of the child – this could make children vulnerable

and is considered poor practice. For a child/young person these details should be those of the parent/carer.

£30.00 1^st October 2011 (£6.50 SSE + £23.50 SZR)

*£15.00 1^st October 2011 (*Only for Children 5yrs & under)

Individual Membership Child (6yrs & Above)/Adult (£30.00)

Individual Membership Child (5yrs & Under) (15.00)

Family Membership (up to 2 people) (£50.00)

Additional family members at the same address (£25.00)

Cheque payable to: “SZ Racing Club”

Date membership paid _________________ Amount £_________________

PLEASE COMPLETE FOR EACH FAMILY MEMBER:

Name

Disability

The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial long-term adverse effect on his or her ability to carry out normal

day-to-day activities’.

Do you consider yourself to have a disability?

Yes

If yes, what is the nature of your disability?

Please detail below any important medical information that our coaches/junior coordinator should be aware of

Visual impairment			Learning disability

Hearing impairment			Multiple disability

Physical disability			Other (please specify)

Medical information

Please detail below any important medical information that our coaches/

Junior Coordinator should be aware of (e.g. epilepsy, asthma, diabetes etc.)

Are you taking any medications?

Do you have any allergies?

Is there anything medically we should know about? Please be specific.

By returning this completed form, I agree to my son/daughter/child in my care taking part in the activities of

the club.

I understand that I will be kept informed of these activities – for example timing and transport details.

I understand in the event of injury or illness all reasonable steps will be taken to contact me, and to deal with ]]that injury/illness appropriately.

Name of parent/carer:

Signature of parent/carer: Date:

Send completed forms to: SZ Racing Club, ^C/_O Helen Chapman, Welfare Officer, Mayville, Town Street, Shiptonthorpe, York, YO43 3PE

Dear Parents and Carers

Permission for children to be photographed & video

From time to time, we would like your consent to video your child at training sessions. These video’s are solely used as a training aid at SZ Racing Club. We would also like to take photographs, usually in groups or occasionally, individually, to appear in the newspaper or in publicity material. (Special events, achievement etc). We do not allow the children’s names to appear with the photograph unless we have gained your permission first.

For a variety of reasons, some children cannot be photographed and some parents and carers do not wish their child(ren) to appear in papers or other publicity materials.

Please complete the slip below indicating your wishes and return it to us with the membership form.

Your sincerely

Mr Lee Cosham

Chairman/Head Coach

……………………………………………………………………………………………………………………...

Photographs by SZ Racing Club

Child’s name…………………………………………………

I/We give/do NOT give permission for my/our child to be photographed

(Delete as necessary)

Name of parent/carer:………………………………………….

Signature of parent/carer:……………………………………… Date:…………………………………….

FOR INFO ONLY by Snowsport England Regulations and Policy:

REGISTRATION - NOMINATION OF CLUBS

The following notes clarify the existing Snowsport England Regulations and Policy.

CLUB MEMBERSHIP: When you register or renew with Snowsport England as an Alpine Performer, you may

nominate one club for artificial slope racing (including indoor snow) and one club for alpine snow racing. Please

also state your membership or ID Number with these clubs on the registration form.

If the club(s) you nominate are not affiliated to Snowsport England, then you will be required to pay an extra fee to

cover you for Public Liability Insurance. This fee will be shown on the registration and renewal forms.

BEFORE YOU NAME YOUR CLUBS, YOU SHOULD READ THE FOLLOWING CAREFULLY

The Snowsport England Regulations state:

Competitors may register with their National Governing Body without being a member of any club.

Competitors may train with and/or be members of any number of ski clubs. However, they may compete for ONE

CLUB ONLY in Snowsport England alpine snow competitions and ONE CLUB ONLY (which may be the same

club) in Snowsport England artificial slope (including indoor snow) competitions. These must be named on their

registration or renewal and may only be changed during the registration year by following the procedure given

below.

The named club will be shown on all seed lists and race documentation, and the club shown on the current seed

list will be used as the definitive club for inter-club and inter-regional competitions. Only clubs, which at the time of

renewal or registration are in current membership of Snowsport England, Snowsport Scotland, Snowsport Wales,

Northern Ireland Ski Council or BARSC, will be accepted. A list of member clubs will be published annually and is

available from Snowsport England office or at www.britski.org or at www.snowsportengland.org.uk

Competitors wishing to change either of their named clubs during the registration year may only do so by:

a) Notifying their current named club and proposed named club in writing of their intention to change their

Snowsport England named club, and

b) Sending a copy of both notifications to Snowsport England office, enclosing a £5 administration fee and asking

Snowsport England in writing to change their named club.

The change will not come into effect until it appears on the current BARTS or BASS list. In order that the change

can be effected on the next published seed list, the notification must be received by Snowsport England office not

less than one week before the published cut-off date for the seed list concerned. Any notification and fee received

after this date will not come into effect until the start of validity of the following seed list.

Send completed forms to:

S Z Racing Club, ^C/_O Helen Chapman, Welfare Officer, Mayville, Town Street, Shiptonthorpe, York, YO43 3PE