TTAC Summer Registration
Email address *
Program Registering For: *
Swimmer's First Name *
Your answer
Swimmer's Middle Initial *
Your answer
Swimmer's Last Name *
Your answer
Date of Birth *
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Age *
Gender
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone *
Your answer
Emergency Contact and Phone Number *
Your answer
Medical Concerns- Please complete form and discuss with coaches prior to the start of the season
Prior injuries
Your answer
Photo Release: Release for Sharing Swimmer Images TTAC, through its web site, social media and press releases would like to publish swimmer pictures to share with our club and the public. The reasons for publishing swimmers pictures are:1. To give the swimmers a feeling of accomplishment. To share memorable moments with the club.3. Giving members a place to look at all the pictures taken at the meets and Fun Days. TERMS OF CONSENT We understand that our child’s physical image may be considered for publication on the TTAC website, social media accounts or with a press release to local media. Further we understand that with such use no home address or telephone number will ever appear with that child’s image. Please indicate your agreement with the above statement or select the second option if you do not want your child's picture shared *
Please Note: I understand that there is risk to my child and myself being injured and that the risk is inherent to all sports and activities. I further understand that the risk of injury may be severe, including the risk of fracture, brain injury, paralysis or even death. I acknowledge that the Tri-Town Aquatic Club and the Iroquois Central School District DOES NOT have and DOES NOT provide Accident and Health Insurance policies/coverage for sponsored program participants, spectators or volunteers. It is strongly recommended that all participants be covered by their own Accident & Health Insurance Policy. I further understand that participants, officials, timers, spectators and volunteers are in fact participating at their own risk. In the event of injury, I hereby give authorization for emergency treatment and transportation of myself or my child. By checking this box you have read and hereby acknowledge the above statement *
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