THOMPSON PARK DOLPHIN SWIM TEAM

REGISTRATION FORM

PLEASE FILL OUT ONE FORM FOR EACH SWIMMER IN YOUR FAMILY


Swimmer’s Name:______________________________________________________________


Gender: M F Birthdate: _____/_____/______ T-Shirt Size: Adult or Youth S M L XL XXL


Parent/Guardian: ______________________________________________________________________


Mailing Address: _______________________________________________________________________


Home Phone: ______________________________ Work Phone:______________________________


Cell Phone:________________________________ Other Phone: _____________________________


Swimmers Cell Phone: ______________________ Email Address: ____________________________


CONSENT AND AGREEMENT

I or we the parents of the above named minor, do hereby give my or our consent for myself or the above named minor to become a member of the Thompson Park Dolphin Swim Team and to participate in the Ohio Valley Swim League. Likewise, I or we understand that the Thompson Park Swim Team is a volunteer organization and in consenting for myself or the above named minor to become a member of the Thompson Park Dolphin Swim Team, I or we become members of the organization and agree to donate my or our time as needed and available to assist the team in any way.


Swimmer’s Signature (if 18 or over): __________________________________________ Date: ____________


Parent/Guardian Signature: __________________________________________________ Date: ____________


WAIVER FORM


I or we the parents of the above named minor understand that there exists certain risks of injury in competitive swimming events with proper instruction including, but not limited to, injuries from diving improperly, diving in shallow water, striking the head during the backstroke, turns or relays, injuries from other swimmers, hyperventilating and travel to and from events. Such injuries may result in paralysis or death.


I or we further understand that the Ohio Valley Swim League, its member teams and the Thompson Park Dolphin Swim Team provides no liability or medical insurance to any swim team member who may be injured.


Likewise, I or we understand that emergency medical personnel and treatment may not be available at the accident site.


Therefore, I or we hereby waive any and all claims, demands, or causes of action which could be brought against the Ohio Valley Swim League, its member teams, Thompson Park Dolphin Swim Team, its members, coaches, staff, volunteers, agents or employees for any cost, damages, loss of services or expenses on account of or in any way growing out of any injury which may occur to me or our child(ren) while transporting to and from or participating on the Thompson Park Dolphin Swim Team in the Ohio Valley Swim League and waive any and all claims, demands or causes of action which could be brought against the city of East Liverpool, Ohio, Thompson Park and its employees.


Further, I or we agree to indemnify and save harmless the Ohio Valley Swim League, it member teams, the Thompson Park Dolphin Swim Team, its members, coaches, staff, volunteers, agents and employees from any claims or actions brought against them at any time on behalf of myself or our child(ren) for any injuries received while transporting to or from or participating on the Thompson Park Dolphin Swim Team in the Ohio Valley Swim League.


Swimmer’s Signature (if 18 or over): ________________________________________ Date: ____________


Parent/Guardian Signature: ________________________________________________ Date: ____________