Racquetball Canada

Are you a new or renewing member? *

I am new to Racquetball Canada
I am already a member or am renewing my membership
with Racquetball Canada

First Name *

Last Name *

Gender *

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Club

Date of Birth * (YYYY-MM-DD)

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Membership Specific Information

PREMIUM Membership ($55.00): Includes everything in Gold plus bonus material.

GOLD Membership ($40.00): Includes everything in Silver plus participation in Open and National Events.

SILVER Membership ($20.00): Includes everything in Bronze plus participation in Provincial events.

BRONZE Membership ($5.00): Allows access to webinars, virtual events, coach and official education opportunities and insurance.

Membership type

Membership type *

Category *

Contact Details

Full Mailing Address - Street Address *

Address 2

City *

Province/Territory/State *

Country *

Postal Code *

Individual Email * Opt in to emails

Cell Phone * - International Number

Work Phone - International Number

Region

I agree to receive email communication from Racquetball Canada related to information about news, events and opportunities for me to be engaged in the sport. I can opt out of this communication at any time. *

Yes No

I agree to receive email communication from local province about about news, events and opportunities for me to be engaged in the sport. I can opt out of this communication at any time. *

Yes No

I agree to receive email communications from my local racquetball club about news, events and opportunities for me to be engaged in the sport. I can opt out of this communication at any time. *

Yes No

Additional Information

Sport Canada would like to know a few things about you.

Para-athlete

Yes No Prefer not to answer

Canadian Citizen

Yes No

Birth Country

Indigenous

New Canadian

Coach/Official Specific Information

NCCP Coaching Number

Are you an active official?

Yes No

Are you an active coach?

Yes No

Criminal Record Check (Submitted Date)

Criminal Record Check (Completed Date)

Criminal Record Check (Expiry Date)

Respect in Sport Certification #

Official Level

Official Level date achieved

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone - International Number

Emergency Contact Email Opt in to emails

Membership type

Membership type *

Category *

Waivers

I have read and agree *
Release of Liability, Waiver of Claims and Indemnity

I have read and agree *
Informed Consent and Assumption of Risk

I have read and agree *
Canadian Anti-Doping Program (CADP)

I have read and agree *
Racquetball Canada Code of Conduct and Ethics

I have read and agree *
Racquetball Canada Media Release

I have read and agree *
Racquetball Canada Concussion Policy

I have read and agree *
Racquetball Canada third party independent hotline

Digital signature (type your name exactly as entered above "registrants name") *

Racquetball New Brunswick

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Membership Specific Information

Membership type

Contact Details

Additional Information

Coach/Official Specific Information

Emergency Contact Information

Parent/Guardian Information

Membership type

Membership type

Waivers