SWIMMER INFORMATION PRIMARY CONTACT INFORMATION

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