KSSSC Registration 2019-2020
Electronic Registration form. By filling out this form you agree that the information is correct and current.
Email address *
Stream / Team Level: *
Your answer
Swimmer Name
Your answer
Swimmer Age
Your answer
Stream / Team Level:
Your answer
Swimmer Birthdate
Your answer
Swimmer Address:
Your answer
Parent/Guardian Name 1:
Your answer
Parent/Guardian Name 2:
Your answer
Parent/Guardian Address 1:
Your answer
Parent/Guardian Address 2:
Your answer
Parent/Guardian Phone 1:
Your answer
Parent/Guardian Phone 2:
Your answer
Parent/Guardian Email 1:
Your answer
Parent/Guardian Email 2:
Your answer
Emergency Contact Name & Phone
Your answer
Family Doctor Name & Phone:
Your answer
Swimmer Medical Plan #:
Your answer
Swimmer Allergies/Conditions/Concerns:
Your answer
Check the box to agree
I give my permission for images of my child to be used in promotions such as newspaper, Sunrays website, advertisements, flyers and TV or video provided they are approved by the Synchro Club.
In accordance with the Privacy Act, information on this form is collected to meet our liability insurance requirements, to assist with billing, to register swimmers for competitions, and to efficiently contact our swimmers and their families. I give permission for the Kamloops Sunrays to use information in this way and to include my phone number and e-mail address on the club’s roster.
By registering my child in this club, I am aware that I will be expected to volunteer according to the level my child is swimming.
In consideration of this application being accepted, I, the undersigned, hereby for myself, my heirs, and administrators, waive and release all rights against the “KAMLOOPS SUNRAYS SYNCHRONIZED SWIM CLUB” for any injuries sustained by me at any competition or practice or function held under the jurisdiction of the “KAMLOOPS SUNRAYS SYNCHRONIZED SWIM CLUB” and/or its affiliated sports associations. I further acknowledge that as a parent or guardian of a minor I become a society member of the Kamloops Sunrays Synchronized Swim Club.
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