Wheeling YMCA Cardinal Aquatics Swim Team Registration Information Season

Transcription

1 Wheeling YMCA Cardinal Aquatics Swim Team Registration Information Season Child/Swimmers Name: Middle Initial Gender Age (age on or after Dec. 1, 2017) Date of Birth / / Grade: School: Address: City State Zip Home Phone: Cell phone: Parent or Guardian Name(s): Address (if different from above): Home Phone (if different from above) Cell Phone address (Please print early) (used for your swimming account) Please check One: I will obtain a membership through the Wheeling YMCA Cardinal Aquatics Team. I will be billed $205 for individual and will pay this by October 1, Checks written to WHY Cardinal Aquatics. Please put in payment box or give to Stephanie Fogle or a board member during sign ups. Please get a Y registration card and fill this out and we will turn this in to the

2 YMCA on your behalf. (It helps the team if you get a membership through us and you enjoy the same great benefits at the YMCA.) I currently have or will obtain a membership directly through the YMCA Expiration Date: / / Please provide a copy of your card to the team. Memberships are verified with the YMCA annually. I will renew with the swim team and pay $205 per child. Checks payable to the team and your account will be updated from the expiration date through the following year. You may pay this before your card expires. If your membership card expires in the fall please pay as soon as possible (October through November). If it expires in January or later please pay by January-February.. Thanks! If you are a US Swimmer, please complete the following: US Number: Expiration date: / / I will renew at $74 per swimmer. I will not renew. This check is also made out the WhY Cardinal Aquatics and the head coach renews them as a team. You should get your cards by January as they expire in December. Enclosed is my payment. I will pay at a later date. This will be Due in December. REGARDING MEET FEES: Each month please pay the meet fees for that month so that balances will not be out of hand at the end of the year. This will help you and the team. Large outstanding balances may be deemed unable to participate at the end of season meets. Thank you.

3 Emergency Consent Information Child/Swimmers Name: Parent/Guardian name(s) and place of Employment: Phone: Phone: Cell Phone: Cell Phone: Friend or relative who will assume temporary care of your child if you cannot be reached: Name Relationship to swimmer: Address: Phone: Cell Phone: MEDICAL INFORMATION (MUST BE COMPLETED) Swimmers Physician: Physicians hone Preferred Hospital Health Ins. Carrier Policy Holder s Name Policy #

4 Health Information: Please list any pertinent health conditions or chronic condition that your child may have: Medication your child is taking for any of the above conditions: ** To the parent: Feel free to inform the coach if there a medical concern with your swimmer. My child has had a physical in the past 12 months : Date: / / I authorize the coaches or parent officers of the Wheeling YMCA Cardinal Aquatics Swim Team to contact person(s) named on this paper and authorized named physician(s) to render such treatment as may be deemed necessary in an emergency. In the event person(s) named above cannot be contacted, Swim Team coaches and parent officers are authorized to take whatever action is deemed necessary in their judgment for the health of the above-named child. I will not hold the Wheeling YMCA Swim Team, its coaches or officers financially responsible for the emergency care and/or transportation of the above-named child. Parent/Guardian Signature: Date: Wheeling YMCA Cardinal Aquatics Fees Schedule YMCA MEMBERSHIP IS REQUIRED REGARDLESS OF SWIMMERS AGE OR PARTICIPATION LEVEL. Please read below The team must have a copy of the current carrent card by October 1, Swimmer(s) name

5 Parent acknowledgement Team Fees: $400 for one swimmer, $380 for each additional (final payment by end of December) (Minimum $100 payments or $100 each and one of $80). YMCA Memberships please pay in full. **If Paid in Full by Sept. 29 th, $370 for one swimmer, $350 for each additional Initial DELINQUENT ACCOUNTS: Accounts that are 15 days past the due date will be suspended. What this means is that you will not be able to enter the swimmer in any meets until the amount is caught up and the swimmer cannot practice. Also, delinquent accounts from the past year will not longer be eligible for the payment plan and will have to pay all registration and Y fees up front and meet fees will need to be paid in full on a monthly basis. Any apparel purchased will have to be paid prior to the order being placed for those individuals. Account Balances: Accounts should not carry more than a $100 balance after January 1, Questions: Stephanie Fogle, Treasurer at Initial *****PARENT PARTICIPATION:

6 Swim meets rely on parent participation in order to run smoothly. Please understand there are swim meets that we will expect parents to work and will usually have sign ups for jobs in advance. 4 points will be required and jobs at home meets. There will be a sign up on line. If you have trouble getting points please inquire on what you can do to help later in the year. Four credits will be required and you will be charged $30 for each point on your account and then you will be credited $30 for each shift worked as the season progresses. **** FOR PRIOR MEMBERS OF THE TEAM**** Please pay any balance due the team by the first practice your swimmer is attending in order to be eligible.