OBSA - Ontario Blind Sports Association

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OBSA Code of Conduct/Waiver

Upon acceptance as a member of the Ontario Blind Sports Association, I agree to abide by the rules and procedures of the Association as approved through Rules, by-Laws and Regulations. As a member of the Association I shall uphold the high standards of the Association and shall never do anything to damage the reputation of the Association. I understand and agree that the Association and/or any of its officials, affiliates or sponsors are not responsible for any injury, damage or loss resulting from any accident from known or unknown conditions howsoever caused. I also understand and agree that any violation of this contract will result in the immediate termination of my membership.

Member Status	New Member Renewal
Member Since
CNIB Number
Membership Number
First Name *
Middle Initial *
Last Name *
Sex *	Female Male
Date of Birth *
Mailing Address *
Apt #
City *
Province/State: *
Postal Code *
Country *
Email Address *
Home Phone *
Business Phone
Fax
Membership Affiliation *	Athlete Coach Official Support PSO Rep Other
I would like to receive private messages *
Send me email notifications when I receive a private message. *
Signup for OBSA Newsletter? *
Sports Club (Complete the following if you belong to a club, please include Club Name, Address and Contact Person )
Health Insurance Number
Health Information (i.e., allergies, medication, etc.)
Emergency Contact Person
Relationship to Emergency Contact ( e.g. Mother, Brother etc.)
Emergency Contact Phone Number (Home)
Emergency Contact Phone Number (Work)
Please indicate sports you Actively Participate in	Track Wrestling Goalball Powerlifting Judo Field Swimming Other
Please Indicate if you are Interested in the following Sports	Track Wrestling Goalball Powerlifting Judo Swimming Field Other
Please indicate your Classification ( T11, T12, T13, F11, F12, F13 or Swim Classification) if active in Track, Field and/or Swimming
Please indicate what format would you prefer to receive a newsletter in	Electronic (via email) Braille Large Print Regular Print
Code of Conduct. Do you agree to abide by the OBSA's Code of Conduct? (please see Code of Conduct description below) *	Yes No