2021 NCS A-Team Camp Application Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

YOU MUST APPEAR ON THE LIST BELOW TO APPLY.

https://swimnc.com/wp-content/uploads/2021/09/2021-NCS-A-TEAM-SWIM-CAMP.pdf

CAMP FEE:

I understand that this application is not complete until I submit payment of $60 for the A Team Camp fee using the PAYPAL link below. A-TEAM CAMP FEE IS NON-REFUNDABLE.

SUBMIT PAYPAL PAYMENT (click the following link to connect with PayPal)

https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=RCB8U28KJRJBG

CONSENT and RELEASE STATEMENT:

I agree to allow my child to participate in the one-day 2021 A-TEAM Camp at the Sportsplex in Hillsborough, NC on Sunday, Nov 7, 2021. I further agree to release from all liability USA Swimming, Inc., NC Swimming, Inc., the event organizers, staff, manager, chaperones, and facility host Triangle Sportsplex for any and all injuries suffered by my child during the weekend camp. I understand that if my child violates the NCS Code of Conduct while on this trip that he or she can be dismissed immediately from the camp and that I am responsible for providing my child with transportation to and from the A-TEAM Camp activities. Further I authorize medical personnel to treat my child should an emergency arise and medical care be needed.

NC SWIMMING A-TEAM CAMP CODE OF CONDUCT: (click the following link to view)

https://swimnc.com/wp-content/uploads/2021/09/NC-SWIMMING-CAMP-CODE-OF-CONDUCT.pdf

APPLICATION DEADLINE: October 1, 2021

Email *

Parent Electronic Signature *

I have read and agree to all of the above - type in your full name

Athlete Electronic Signature *

I have read and agree to all of the above - type in your full name

Athlete's Last Name *

Athlete's First Name *

Preferred Name *

Street Address *

City/State/Zip *

Home Phone *

Parent's Cell Phone *

Athlete's NC Swimming Club *

Athlete's Current Club Coach *

Parents'/Guardians' Name(s) *

Athlete's T-shirt size *

Adult Small

Adult Medium

Adult Large

Adult X Large

Athlete's Jacket size *

Adult Small

Adult Medium

Adult Large

Adult X Large

Emergency Contact Name *

Emergency Contact Phone Number *

Doctor's Name *

Doctor's Phone Number *

Medical Insurance Carrier and Member Number *

Known Medical Conditions or Allergies (including food allergies) *

List any special dietary needs or restrictions *

The $60 Camp Fee has been paid through PayPal. *

YES, I am on the A-TEAM list and have paid the $60 camp fee through PayPal

Required

I understand that the Camp Fee is non-refundable. *

YES

Required

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms