2019 Registration - Swim Team If you are human, leave this field blank. Parental Contact Information Parent First Name * Parent Last Name * Email Address * Phone Number * Swim Team Fees The first swimmer is $60. Second swimmer is an additional $50. All other additions past two swimmers is $40. How many swimmers are you registering? 1 Swimmer: $60 2 Swimmers: $110 3 Swimmers: $150 4 Swimmers: $190 Competitive and Pre-Competitive Definitions The Competitive Program will be geared towards each swimmer’s experience and ability, emphasizing stroke technique, endurance, and speed. Morning and evening practices offered during the season. Participation in swim meets is expected! The Pre-Competitive Program will be designed for those who can swim one lap in deep water confidently (any stroke). (A pre-competitive evaluation will be held in the beginning of the season to determine if the participant is ready.) The program will focus on technique, not endurance. The coaches reserve the right to place a participant into either the competitive or preAcompetitive program. Swimmer Registration First Name * Last Name * Date of Birth * Do any of the swimmers have any medical conditions such as asthma, seizure disorder, etc.? * Yes No Please identify the swimmer and elaborate on the condition: * Add Another Swimmer Remove Last Added Swimmer Liability Liability Waiver * I understand the Team/Club cannot be held responsible for any injuries to it’s members and agree that each member will provide for, and pay the cost of his/her own medical care. I also certify that my child(ren) participating in this activity is in proper physical condition for this activity. In case of emergency I give permission to contact the nearest medical care available in order to apply such medical services as are necessary for the well being of my child(ren). This permission includes the authority to transport my child to a place where such medical care is available. Billing Information Please enter billing info as it appears on your credit card First Name Last Name Address City Zip State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Payment Total for Swim Team Registration $ Credit Card Credit Card Credit Card Credit Card Month 1 2 3 4 5 6 7 8 9 10 11 12 Credit Card Year 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 Credit Card Signature * Draw It Type It Clear
