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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.

Email address *
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
Is the athlete a US Citizen? *
Was the athlete a member of another USA Swimming Club team in past years? If so, which team? *
Your answer
Does your athlete have a physical or intellectual disability of any sort? If so, please list:
Your answer
Swimmer's T-shirt Size *
"Sign" your acknowledgment below by printing your name. (First, Last). 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. *
Your answer
A copy of your responses will be emailed to the address you provided.
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