Offical Use: Cash/Check# (initials) Amount paid Date MAPLEWOOD SWIM CLUB SWIM AND DIVE TEAM REGISTRATON FORM 2018 PARENT(S)/GUARDIAN(S): (Last) (First -both parents) MEMBER#: CELL PHONE#: EMAIL ADDRESS(ES): ATHLETE NAME BIRTHDATE AGE ON 6/1 GENDER SWIM DIVE SHIRT SIZE AMOUNT Fee Structure- 1st athlete: $95; 2nd $85; 3rd,4th,etc, $40 each Sub-total: * There is a separate registration form Team Suit for swim lessons and junior swim team * Female $43 x = Male Jammer $29 x = Male Brief $26 x = ** Optional Pre-pay ** Family Day /Raffle Fee for baskets $10 (or due 6-29) Champs t-shirt $12 x = Applebee's Breakfast tickets $7 x = (Note: tickets purchased at the door are $8 per person) Swim-A-Pool-ooza $15 per swimmer or $25 per Family = Banquet $8 per person x = Coaches' gifts at banquet $5 per athlete x = (cash or check payable to Maplewood Swim Club) TOTAL: Refund Policy - Please submit a refund request via email to mwdswimteam@gmail.com. Verbal requests will not be honored. Refunds will be prorated, using the first day of practice as the start date. There will be no refunds after July 1.
EMERGENCY INFORMATION AND RELEASES - 2018 Last Name: Athlete Name(s): Home Phone: Cell Phone (mother/guardian): Cell Phone (father/guardian): Emergency contact information (if parent(s) or guardian cannot be reached) Name Relationship to family: Cell Phone: MEDICAL INFORMATION Major illnesses / recurring injuries or illnesses / allergies / current medications: (Please indicate athlete's name if more than 1 member in the family) RELEASES: As the parent and/or legal guardian of the above-mentioned minor(s), I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well being of my dependent(s). Signature: Date: I, the parent and/or guardian of the minor(s), recognize the possibility of physical injury associated with swimming/diving and consideration for the Maplewood Swim Club Swim Club against any claim by or on behalf of the minor(s) as a result of the minor's Signature: Date:
PARENT VOLUNTEER Last name: Athlete's last name (if different) Your help is needed and appreciated throughout the entire swim season. It takes many parents to help run a swim and dive meet successfully. A parent volunteer schedule will be emailed and posted closer to the start of our meets. You will be randomly assigned a date for a snack bar donation or baked goods donation for a swim meet or team banquet. Stroke and Turn Judges. If you are interested, you must attend one Stroke & Turn Judge Clinic * If you are a Stroke & Turn Judge for a 2018 swim meet, you MUST attend a clinic. Dates: June 5th 7pm at William Tennent High School Room E106 and June 14th at Maple Manor 7pm Diving Judge Clinic June 12th 7pm @ Hideaway Swim Club- diving parents must attend ** parents of divers are needed at all meets - must attend training clinic to learn or refresh Diving Judge position. Indicate position(s) you have worked(w) or have interest in being trained to work (T): READY BENCH TIMER TIME RECORDER HEAD TIMER PLACE JUDGE COMPUTER OPERATOR TABLE SCORER STROKE & TURN JUDGE (must attend clinic) RUNNER 50/50 TICKETS SWIM MEET ANNOUNCER DIVING ANNOUNCER DIVING JUDGE DIVING SCORE TABLE SNACK BAR (Please note: if you are a parent of an 8&Under or 10&Under swimmer you may be assigned to work Ready Bench for 1-2 meets) PLEASE CIRCLE THE MEET DATES THAT YOU KNOW YOU WILL NOT BE ABLE TO VOLUNTEER: THUR JUNE 21 Home vs Maple Manor TUE JUNE 26 AWAY vs Manorlu SAT JULY 7 AWAY vs Hideaway THUR JULY 12 HOME vs Fort SAT JULY 14 AWAY vs Upper Moreland TUE JULY 17 HOME vs Sunny Willow ** If your swimmer/diver is unable to participate in a meet, please notify head swim or dive coach. These dates circled above pertains to parents unable to work certain meets. ** You will be notified via email of the meet worker schedule & snack bar donation. There will also be a schedule posted on the swim team bulletin board. If you are scheduled to work a meet, but are unable to do so, please find a replacement and notify us via email at mwdswimteam@gmail.com
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