Sunrise Swans 2018 Registration

Payment will be due at the start of season. Please bring cash, check, or credit card on the first day of swimming.

2018 Season: $320 ($290 Sibling Discount)

*** Refer a Friend who signs up and both you AND your friend get $15 Swan Bucks (Can be used at the snack bar and/or for swans merchandise)***

http://www.sunriseswans.org/

Swimmer's Information

Swimmer's First Name *

Swimmer's Last Name *

*

Returning Swimmer

New Swimmer - Referred by (if applicable) New Swimmer - Referred by (if applicable)

Birthdate * +

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Texts Ok

Alt. Phone Number

Texts Ok

Email Address *

Any Allergies

Parent/Guardian Information

Parent/Guardian One

First Name *

Last Name *

Email Address *

Phone Number *

Texts Ok

Address - Same As Above

Street Address

Address Line 2

City

State

Zip Code

Parent/Guardian Two

First Name

Last Name

Email Address

Phone Number

Texts Ok

Address - Same As Above

Street Address

Address Line 2

City

State

Zip Code

Alternate Emergency Contacts

Name *

Relation *

Phone Number *

Name *

Relation *

Phone Number *

Authorization to render emergency care: (Please check the desired action) *

In the event of an accident or emergency, the undersigned hereby authorizes a representative of the Sunrise Swans Synchronized Swimming Team, including coaches, lifeguards, and parents volunteers/chaperones, to make such arrangements as he/she considers necessary for the swimmer to receive medical care from an emergency medical team or to be transported to medical facility for further treatment by any liscensed physician while the swimmer is under the supervision of the team.

I / We do not choose the above option for the following reason: I / We do not choose the above option for the following reason:

Parent / Guardian Signature: *

clear

Date * +