Remix Baton 6 Week Program Registration Form

2021 Winter 6-Week Program Registration

REMIX BATON CLUB
Program Information
- Loaner batons will be provided.
- Classes begin:
Tuesday, November 16th, 2021

5:00 pm - 6:00 pm

OR 6:00 pm - 7:00 pm.

OR 7:00 pm - 8:00 pm.

at Ranchlands Community Association, NW Calgary.

Wednesday, November 17th, 2021

6:00 pm - 7:00 pm

at Sarah Thompson School, Langdon.

Friday, November 19th, 2021

6:00 pm - 7:00 pm

OR 7:00 pm - 8:00 pm.

at Rally Pointe Volleyball Centre, SE Calgary.

Tuesday Class dates as follows:
- Tuesday, November 16th
- Tuesday, November 23rd
- Tuesday, November 30th
- Tuesday, November 24th
- Tuesday, December 7th
- PERFORMANCE OPPORTUNITY - Recital Saturday, December 11th (Afternoon/Evening)
- Tuesday, December 14th
Wednesday Class dates as follows:
- Wednesday, November 17th
- Wednesday, November 24th
- Wednesday, December 8th
- PERFORMANCE OPPORTUNITY - Recital Saturday, December 11th (Afternoon/Evening)
- Wednesday, December 15th (Camp Chestermere Location)
Friday Class dates as follows:
- Friday, November 19th
- Friday, November 26th
- Friday, December 3rd
- Friday, December 10th (Auburn Bay Residents Association Location)
- PERFORMANCE OPPORTUNITY - Recital Saturday, December 11th (Afternoon/Evening)
- Friday, December 17th
**All days, times and locations are subject to change throughout the season due to gym availability.**

2021 Winter 6-Week Program Registration

REMIX BATON CLUB
Athlete's Full Name *

First Name Last Name
Birthdate *

Month Day Year
Date
Age *
As of December 31, 2018
Parent Full Name *

First Name Last Name
E-mail *
Address *

Street Address

Street Address Line 2

City Province

Postal Code
Home Phone Number *

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Emergency Contact *

First Name Last Name
Relationship *
Emergency Home Phone *

Area Code Phone Number
Emergency Cell Phone

Area Code Phone Number
Medical Concerns
Class Selection *
One time registration fee for the 6-week program. *

$50.00
All forms of payment can be accepted.
Payment Options *

Pay Now - Credit/Debit Pay Later - eTransfer Pay in Person - Cash/Cheque/Debit/Credit

Registration Fee $ 50.00 CAD

Total $ 0.00 CAD

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Additional Comments

Participant’s Assumption of Risk
2020-2021 Season

I am aware and understand that there are a number of inherent risks involved in my participation in this sporting activity and are beyond the control of the Canadian Baton Twirling Federation, the Provincial Baton Twirling Organization, Association or Corporation in the province in which any competition and/or sanctioned activity in which I participate takes place, the host club(s) or province, the event or competition director, the owner, occupier, operator, and/or tenant of the event facility, and any person, corporation or organization associated with the operation of such competitions or events. I further agree that I am assuming personal responsibility for any costs as well as any loss, damage, injury or ambulance service resulting from or in connection with such participation at each competition in which I compete, or event in which I participate. I have read and understand this Waiver.
Name *

First Name Last Name
Date *

Month Day Year
Date
CBTF Media Consent

Photography/Media Coverage/Website

During the year, photographs of athletes may be taken during competitions, banquets, clinics, awards and special presentations or other occasions. Your consent is required or parental/guardian consent if the athlete is under the age of majority. Media coverage is occasionally done throughout the competition season in order to promote the sport of Baton Twirling and to acknowledge club and athlete's accomplishments. This means publishing of athlete's names and club associations in the local newspapers and on the CBTF website. On occasion the media will attend competitions including radio, television, newspaper etc. At these times, it will be the parents' responsibility to provide parental consent to the specific media outlets.
Do you grant the Canadian Baton Twirling Federation permission to post all forms of publicity including full name and image? *

Yes, permission is granted. No, permission is not granted.
Name *

First Name Last Name
Date *

Month Day Year
Date
Should be Empty:

2021 Winter 6-Week Program Registration

2021 Winter 6-Week Program Registration