MEMBERSHIP PROCESS

Unattached members send form with fees to BC Athletics. Faxed applications with

qMaster 35 + qJr. Road & Trail qRoad & Trail payment by credit card will be accepted. Incomplete forms will be returned.

Upon acceptance as a member of BC Athletics & Athletics Canada, the applicant agrees

to abide by the bylaws, rules & policies of BC Athletics and Athletics Canada as approved

qPresident qSecretary qRegistrar

qTreasurer qHead Coach qOff. Coord. qJD Coord. q Director Sprints q 200m H q 10000m Throws Walks

qEvent Registration Coord. q 60m q 300m H q 1500S/C q SP q 800m

q 100m q 400m H q 2000S/C q DT q 1500m

q 200m Distance q 3000S/C q HT q 3000m

q 300m q 800m Jumps q JT q 5K

Application Date: ____________________ q 400m q 1200m q LJ q 10K

Hurdles q 1500m q TJ q 20K

q 60m H q 2000m q HJ

q 80m H q 3000m q PV qPentathlon qHeptathlon

q 100m H q 5000m qOctathlon qDecathlon

q 110m H

Birthdate: ________________________

ROAD RUNNING q5K q8K q10K q1/2 Mar qMar qUltra

COACHING CERTIFICATION

Surname Given Name Middle Initial Please indicate highest level completed in each component:

Theory: ____ Technical: ____ Practical:____ CC#:_____________

Street Address Event Area Specialty___________________________________

Status: qFull time Paid qPart Time Paid qPart Time Volunteer

City Province Postal Code Nbr. of athletes: Male:_____ Female:____ Age range: _______

( _______) OFFICIALS CERTIFICATION

Area Code Discipline ___________________ q Prov.q 1 q 2 q 3 q 4 q 5

Discipline ___________________ q Prov.q 1 q 2 q 3 q 4 q 5

Discipline ___________________ q Prov.q 1 q 2 q 3 q 4 q 5

Discipline ___________________ q Prov.q 1 q 2 q 3 q 4 q 5

_____________________________ _____________________

q VISA q MC q AMEX

Coach: q Cash q Cheque - payable to BC Athletics

The responsibility for sport safety must be shared by all. I, the undersigned, am aware that there is a

certain risk of injury involved in my own or my child's participation in sport, in sport, either while

travelling to or from the event; or while attending or participating in the programs or activities of the

events which are sanctioned/approved by BC Athletics, its Divisions, its Member Clubs or recognized

organizing societies. It is understood by me that the signing of this document is intended to indicate

on behalf of myself and/or my child I assume the shared responsibility and acknowledge the risk of injury

by so participating.

Applicant signature - ALL applicants must sign

Club Registrar signature - if not signed affiliation will show Unattached

2016-08-11

NON-COMPETITIVE ATHLETES: qTrack Rascals qTraining

Indicate each membership type applied for.

COMPETITIVE ATHLETES: qJunior Development qMidget 14 qMidget 15 Affiliated club members must sign up with BC Athletics through their club registrar.

qYouth qJunior qSenior q Jr Post Secondary q Sr Post Secondary

LIMITED COMPETITIVE ATHLETES: qBC Games 14 q BC Games 15+

by the membership.

See reverse for information and requirements for each membership type EVENT PARTICIPATION

Club Executive/Board: TRACK & FIELD

r BCA Board of Directors _____________________________________________

Month Day Year

BC Athletics Representation: o BCA Committee:______________________

NON- ATHLETES: qCoach qOfficial qAssociate qFriends of BCA

Month Day Year q Female

_____________________________________________________________

___________________________________________________________

___________________________________________________________

Combined Events

previous BCA #

qAthlete with a Disability: Classification__________________ q Aboriginal

q Male CROSS COUNTRY/TRAIL RUNNING q

qNew BCA Member or qRenewing BCA Member - ____ - ___________

Parent / Guardian signature - For applicants 19 and younger

BC Athletics Privacy PolicyBy completing this membership application form, signing and joining BC Athletics you consent to the

BC ATHLETICS INDIVIDUAL MEMBERSHIP APPLICATION FORMBC Athletics

Fortius Athlete Development Centre

3713 Kensington Ave., Suite 2001B Oslo Landing

Membership Types & Affiliations

Bus.Ph:___________________ Bus. Fax:_________________

e-mail:______________________________________________________

_______________________ __________________________________

Res.Ph: ___________________ Res Fax:_________________

granted if applicable

to limit the release of information contact the BC Athletics Privacy Officer, Sam Collier at

sam.collier@bcathletics.org

Membership Fee (listed on reverse) $ __________________

Applicant Occupation (optional) Employer (Optional)

Cardholder Signature

visit the Athlete Zone on the CCES website http://cces.ca/athletezone

the CADP applies to members of Athletics Canada and participants in Athletics Canada sanctioned

activities. All members of Athletics Canada, whether in the role of athletes or athlete support personnel, are

collection of this information and its use as per the BC Athletics Privacy Statement and Policy - see

Identifying Purposes - Appendix II of the Policy available at www.bcathletics.org. For more information or

aware that the CADP applies to me and I consent to its application to me. For further information, please

that govern doping control in Canada. Administered by the Canadian Centre for Ethics in Sport (CCES),

Athletics Canada has adopted the 2009 Canadian Anti-Doping Program (CACP), which is the set of rules

Canadian Anti-Doping Program (CADP)

Expiry Date Amount

__________________________________________________

BC Athletics Club: _________________________________________________________

These three statements are part of the BC Athletics application for membership

Burnaby, BC V5B 0A7

subject to the CADP. By signing below, I acknowledge that I am a member of Athletics Canada and I am

_________________________________________________________

"U" if Unattached Card number

BC Amateur Athletics Association Sport Safety/Acknowledgement of Risk ____________ ____________

______________________________________________

Country of Birth Citizenship - Date Landed Immigrant Status PAYMENT INFORMATION

Terms and Conditions:tMembership year: Jan 1 - Dec 31 each year . A signed form is required. LIMITED COMPETITIVE ATHLETE MEMBERSHIPStMemberships can not be prorated in a membership year. BC Games Memberships:t New members & renewing members who were not members in the previous ∙Liability and Sport Injury/Accident Insurance

membership year, applyng after Aug 31st receive a membership valid BC Games 14 (14 yrs) - $20.00 through to the end of thefollowing membership year ∙Eligible for participaion in the BC Smmer Games when held

t Renewing members who were members in the previous mmebership year ∙Eligible for entry in the Midget Alternate Championships when held

receive a membership for the current year regardless of when they apply. BC Games 15+ (15+ yrs) - $21.00t Age is calculated as of December 31st in the membership year. ∙15 year olds are eligible for participaion in the BC Smmer Games when held

t Multiple memberships pay highest fee over all types applied for ∙15 year olds are eligible for entry in the Midget Alternate Championships when held

t Memberships can be upgraded during the year ∙16+ years - eligible for BC Northern Games where events are offered

t Memberships are non-refundable

t GST is included in fees where applicable NON-COMPETITIVE ATHLETE MEMBERSHIPSt Performances recognized if the athlete has a current, competitive ∙Liability and Sport Injury/Accident Insurance

membership in place at the time the performance is achieved. ∙Not eligible for entry in sanctioned events

tBC Athletics membership is open to all residents of BC living inside ∙Not eligible for the $3.00 Day of Event membership exemption in

the province and those living outside the province due to school or sanctioned events

employment. Contact the BCA office for information regarding Track Rascals (6 - 8 yrs) - $15.00 eligibility to take part in some BCA and Athletics Canada programs ∙A non-competitive entry program for Athletics

regulated by the requirement to be either a Canadian citizen or a Training (9+ yrs) - $15.75 Landed Immigrant - ie: BC and Canadian Team programs and BC and ∙Training/workout only. Not eligible for entry in competitions.

Canadian funding programs. * Post Secondary Team Roster Membership - $21.00

Standard Membership Benefits for all members: * Only available through a Post Secondary (School) Club membership

∙ Athletics Canada membership ∙Valid from Sept 1st to May 30th

∙Insurance coverage as indicated ∙Liability and Sport Injury/Accident Insurance

∙Discounts on goods & services from BCA partners

∙Additional benefits/limitations noted with membership type NON-ATHLETE MEMBERSHIPS

COMPETITIVE ATHLETE MEMBERSHIPS ∙Liability and Sport Injury/Accident insurance

∙Valid for entry in sanctioned events ∙Eligible for Annual Awards

∙$3.00 Day of Event membership exemption for entry in ** Criminal Records Check sanctioned events BC Athletics policy requires a Criminal Records Check (CRC) for COACH, OFFICIAL,

∙Liability and Sport Injury/Accident Insurance & ASSOCIATE members. CRC's are obtained from local Police Stations and RCMP

∙Performances included in Provincial & National rankings Detachments. CRC's must be valid within 4 years of the date of BC Athletics

∙Eligible for annual awards and indicated membership application.

∙Eligible for entry in age category BC Athletics Championships Individuals who are required to have a current CRC as part of their employment

Junior Development (9-13 yrs) - $60.00 and have a CRC on file with their employer can submit a Volunteer Declaration

Pee Wee 9-11 yrs Form (VDF) indicating the organization holding the current CRC. The VDF can be

Bantam 12-13 yrs found on the BC Athletics website at www.bcathletics.org on the "Membership

∙Eligible for inclusion in JD Best Performances Lists. and Clubs" page.

Midget 14 - $70.00 Citizenship - Date Landed Immigrant Status

Midget 15 - $73.00 members submit their CRC/VDGF directly to BC Athletics.

∙Eligible for BC Midget T&F Team selection Memberships will be processed once the current CRC/VDF is received by either

Youth (16/17 yrs) - $94.50 the club Registrar (club members) or BC Athletics (Unattached members).

Junior (18/19 yrs) - $94.50 Additional information can be found at www.bcathletics.org

*Junior Post Secondary (18/19 yrs) - $73.00

Senior (20+ yrs) - $94.50 ** Coach (15+ yrs) - $68.25*Senior Post Seondary (20-22 yrs) - $73.00 ∙Coaching Association of BC Membership

*Discounted membership available with proof of full time ∙Eligible for approved funding for Coaching Education

enrolment in an accredited post secondary institution. ∙Eligible for BC and AC Team Coaching Staff selection

∙Eligible for BC and Cdn. Team selection ** Official (15+ yrs) - $15.75∙Eligible for Athlete funding ∙Eligible for approved funding for Officials Education/Training

Master 35 + - $63.00 ∙Eligible for approved travel support to officiate at sanctioned events

∙Eligible for annual Masters T&F awards only ∙Eligible for National and International Officiating assignments

∙Eligible for entry in Canadian Masters T&F Champonships ** Associate (15+ yrs) - $31.50 ∙Includes an annual CMAA membership. ∙Club Executive and Board members

Road & Trail Memberships: Friends of BC Athletics - $15.75 Junior Road & Trail (18/19 yrs) - $36.75 For those wishing to support the sport of Athletics in BC

Road & Trail (20+yrs) - $52.50 ∙Liability insurance only

∙Eligible for entry in sanctioned RR, CC and T&F All Comers Meets Website: www.bcathletics.org

∙Performances included in Provincial & National rankings BCA Blog: http://bcathletics.wordpress.com/

∙Eligible for entry in Age Division BC CC & RR Championships Join us on facebook - https://www.facebook.com/BCAthletics1

2016-08-11 Follow us on twitter - @BC_Athletics

BC ATHLETICS INDIVIDUAL MEMBERSHIP APPLICATION FORM