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USA Swimming Registration
The Information provided will be kept by the Athens Bulldog Swim Club for its records and databases. It will also be provided to USA Swimming, and the Georgia Swimming LSC, for registration with the USA Swimming organization.

FORM TO BE COMPLETED BY LEGAL GUARDIAN IF ATHLETE IS UNDER 18!

Email Mike Radford (Mike@athensbulldogs.com) with questions, or Ceci Churchwell (Ceci@athensbulldogs.com) for billing questions.

Athlete Name: (First, Middle, Last)
Your answer
Preferred Name: (i.e. The name they go by)
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Current Age:
Your answer
Sex (M/F):
Name of Guardian #1 (First, Last)
Your answer
Name of Guardian #2 (First, Last)
Your answer
Mailing Address: (e.g. 123 Godawgs Ln., Athens, Ga 30604)
Your answer
Parent/Guardian Primary Phone Number:
Your answer
Parent/Guardian Primary Email Address:
Your answer
Is the athlete a US Citizen?
Was the athlete a member of another USA Swimming Club team for the 2016/2017? If so, which team?
Your answer
Does your athlete have any have a physical or intellectual disability of any sort? If so, please list:
Your answer
I acknowledge that the above information is true and accurate. I agree to allow the Athens Bulldog Swim Club to hold the above information for operational purposes. I also agree to allow the Athens Bulldog Swim Club to provide USA Swimming, and the Georgia Swimming LSC, the above information for the purposes of registration with the USA Swimming organization. "Sign" your acknowledgment below by printing your name. (First, Last)
Your answer
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