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Swim Team Registration form

Windy Point Swim Team 2011 Registration Form

Parent Name(s) ___________________________________Pool Membership # _______
Address ________________________________________________________________
Phone (H) _____________ (W) _____________ (Cell) _____________
Preferred E-mail __________________________________________________

Swimmer # 1
Name: __________________________________________________________________
Last First Middle Initial
Date of Birth: _________________ Age as of June 1, 2011: _________
Member of Windy Point Swim Team 2010: Yes ___ No ___ Sex: M ___ F ___
Will be participating in Ft. Eustis pre-season practice? Yes ___ No ___

Swimmer #2
Name: __________________________________________________________________
Last First Middle Initial
Date of Birth: _________________ Age as of June 1, 2011: _________
Member of Windy Point Swim Team 2010: Yes ___ No ___ Sex: M ___ F ___
Will be participating in Ft. Eustis pre-season practice? Yes ___ No ___

Swimmer #3
Name: _________________________________________________________________
Last First Middle Initial
Date of Birth: _________________ Age as of June 1, 2011: _________
Member of Windy Point Swim Team 2010: Yes ___ No ___ Sex: M ___ F ___
Will be participating in Ft. Eustis pre-season practice? Yes ___ No ___

Swimmer #4
Name: __________________________________________________________________
Last First Middle Initial
Date of Birth: _________________ Age as of June 1, 2011: _________
Member of Windy Point Swim Team 2010: Yes ___ No ___ Sex: M ___ F ___
Will be participating in Ft. Eustis pre-season practice? Yes ___ No ___

PARENTS PLEASE READ AND SIGN THE FOLLOWING:
I understand that my help is required at swim meets, both home and away, as well as possibly being called upon for supportive activities to benefit the WP Piranhas Swim Team. I also understand that it is my responsibility to find a replacement should I have a conflict with my assigned job duty and appropriately notify the swim team coordinators. If I am a “no show” and fail to find a replacement, my family will be issued a $50 fine and my child(ren) will be unable to swim until the fine is paid.
__________________________________________________________________________
Signature

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