MARTIAL ARTS SCHOOL PACKET KICK-A-THON DOCUMENTS This is the Martial Arts Schools Packet, for the Kids Kicking Cancer Canada 2018 Kick-A-Thon
MARTIAL ARTS SCHOOL PARTICIPATION & CONSENT FORM COMPETITION Name of School: Name of School Owner(s): Event Coordinator: Email: Phone: School Address: City: Prov: Postal Code: Date of Event: Time of Event: Event Location: Signature of Owner / Authorized Person: Is Shipping Address the same as above? (Circle YES or NO) If NO, please provide an alternative one below: Authorized Person Name / Title / Relationship IMPORTANT: All Forms must be mailed to us in one School package. Package must be postmarked no later than May 25, 2018 to qualify for award determination. Cheques/Money Orders should be made out to Kids Kicking Cancer Canada. We will not accept Cash (please convert to Cashier s Check or Money Order). All donations are eligible for a charitable tax receipt. Please make sure your package includes copies of: School Participation & Consent Form (this form) -signed Permission Slips for each Participant -signed Pledge Sheet for each Participant kick count authorized / $ collection completed Registration Work Sheet for individual participant prize calculations & online donations All checks, money orders, cashier checks (online donations noted on Work Sheet) Please send packet via mail or courier to: Kids Kicking Cancer Canada Attn: Kick-A-Thon 201 King Street London ON N6A 1C9 Permission / consent to Participate, Waiver, Release & Indemnity Agreement: I, for myself and on behalf of the martial arts school and its owner, I am authorized to represent (the School ), consent to participation in the 2018 Kids Kicking Cancer Canada Kick-A-Thon sponsored by Century, including participation through internet based, online activities (the Event ), benefiting Kids Kicking Cancer Canada ( KKC ). The School, myself & /or owner agrees to the use of their name, photographs, voice and likeness in broadcasts, newspapers, brochures, videos, social media and other media without compensation. School acknowledges that all participants are physically fit and able to safely participate in the Event. Schools understand that KKC relies upon Schools to be aware of participant s physical limits, and assume all risk of injury that may occur as a result of participation in the Event. School agrees not to sue, to forever release, indemnify and defend KKC and Century, their affiliates, officers, directors, employees & volunteers (the Released Parties ) from all claims, actions and liabilities of any type, whether it results from an negligent act or failure to act by the Released Parties (including by not limited to, damages for personal injury or death), that arises out of participation in the Event. By signing, I agree to the above.
SCHOOL REGISTRATION WORKSHEET School Owner(s): Event Coordinator: Email: Phone: School Address: City: Prov: Postal Code: Date of Event: Event Location: Instructions Please use the following page on this worksheet to: 1) Log participants on the day of your event. 2) Determine how many of each participant prize items you need to request. 3) Track which prize items go to which participants. 4) Provide a Total of Funds Raised by your School to qualify for Grand Prizes. Please keep a copy of this form for your records and mail a signed copy with your School Package to Kids Kicking Cancer, 201 King St, London ON N6A 1C9. For questions, contact us at 2519-281-5046 or info@kidskickingcancer.ca A (ADULT): S, M, L, XL, 2XL Y (YOUTH): YS, YM, YL TOTAL COUNTS FROM BELOW: Online $: Cheque/Cash $: Total $ Patch #: T-Shirt #: Duffle #:
PARTICIPANT REGISTRATION WORKSHEET PATCH $50 AND UP (MARK) T-SHIRT $100 AND UP (MARK AND SIZE) # PARTICIPANT NAME: PHONE: ONLINE $ CASH / CHEQUE $ TOTAL $ COLLECTED 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 TOTALS: DUFFLE $250 AND UP (MARK)
PARTICIPANT REGISTRATION WORKSHEET (optional additional page) PATCH $50 AND UP (MARK) T-SHIRT $100 AND UP (MARK AND SIZE) # PARTICIPANT NAME: PHONE: ONLINE $ CASH / CHEQUE $ TOTAL $ COLLECTED 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 TOTALS: DUFFLE $250 AND UP (MARK)