SWIM TEAM REGISTRATION FORM SUMMER 2015 SWIMMER INFORMATION Full Name First Middle Gender (check one) Date of Birth Swimmer’s Experience Level (check any that apply) across the pool, but stops occasionally -3 strokes correctly Practice Time Preference (check one) Last Age (as of June 1st) Preferred Name Grade (starting in fall) Training Group (check one based on age as of June 1st) -Under -8 -10 11-12 13-14 -18 Morning Home Address Doctor’s Name Doctor’s Phone ( Medical Conditions/Allergies Medications Member # ) Primary Email(s) PRIMARY CONTACT INFORMATION Father/Guardian’s Name First Last Mailing Address Home Phone ( ) Cell Phone ( ) Work Phone ( ) Mother/Guardian’s Name First Last Mailing Address Home Phone ( ) Cell Phone ( ) Work Phone ( ) Emergency Contact #1 Name Emergency Contact #1 Phone ( ) Relationship to Swimmer Emergency Contact #2 Name Emergency Contact #2 Phone ( ) Relationship to Swimmer Sapona Ridge Country Club 439 Beaver Creek Road Lexington, North Carolina 27295 336.956.6245 VOLUNTEER REQUIREMENTS & MEET ATTENDANCE SRCC Swim Team is run entirely by unpaid volunteers, with the exception of our head coach. In order for the things to run smoothly, we need each family to commit to help volunteer during at least 2 (two) of our dual meets. Please check your preferences (we will try to honor your requests). Feel free to check more! No prior experience is needed. Training is available when needed. For a list of descriptions please see VOLUNTEER POSITIONS located on our website: www.saponaridgesharks.weebly.com (click on the Practices and Meets). Also, please check the box for the meets your swimmer WILL attend. (If you are uncertain, you can leave it blank.) Volunteer Positions (Please select 2 or more) Tuesday, June 16 Home Meet vs. Midway Tuesday, June 23 Away Meet @ Denton Tuesday, June 30 Home Meet vs. Welcome Tuesday, July 7 Away Meet @ Reeds Friday, July 17 County Meet @ Welcome (ages 11-18) Saturday, July 18 County Meet @ Welcome (ages 10-under) Head Timer Timer Runner Clerk of Course Assistant to the Clerk of Course Computer Operator Referee/Starter Stroke/Turn Judge Age Group Leader Assistant to the Age Group Leader Swimmer Tent Supervisor LIABILITY WAIVER By submitting this registration, I acknowledge that swimming has inherent risks and by my signature hereby release and agree to hold Sapona Ridge Country Club, its members, owners, and employees harmless from any and all liability for loss, injury or damages resulting from my and/or my child’s voluntary participation as a member of the swim team. Parent/Legal Guardian Signature Date PHOTO RELEASE I grant to Sapona Ridge Country Club, its representatives and employees the right to take photographs of me and my family in connection with the Sapona Ridge Country Club Swim Team. I authorize Sapona Ridge Country Club, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Sapona Ridge Country Club may use such photographs of me and my family for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. Parent/Legal Guardian Signature Date Please bring completed registration form(s) to the first practice along with cash payment. ($40/first swimmer and $25/each additional swimmer) For SRCC Swim Team Use Only Coaches Copy ____ Computer Operator Copy ____ Amount Paid ____ Date ____ Sapona Ridge Country Club 439 Beaver Creek Road Lexington, North Carolina 27295 336.956.6245
© Copyright 2024