2017/2018 Hamilton Aquatic Club Swimmer Registration
Registration for the Hamilton Aquatic Club's 2017/2018 Season
Email address
Swimmer's First Name
Your answer
Swimmer's Last Name
Your answer
MALE/FEMALE
Swimmer's Birthdate
MM
/
DD
/
YYYY
Swimmer's Registration Level
Please select what level your child is registering for.
Was this level recommended to you by your Swimmer's Coach?
Mailing Address - Street Name and Number
Your answer
City
Your answer
Postal Code
Your answer
Main Phone Number
Your answer
Main Email
This Email will be used for all HAC information sharing for the 2017/2018 season.
Your answer
Custody
#1 Parent/Guardian's Name
Your answer
#1Parent/Guardian's Cell Phone Number
Your answer
#1 Parent/Guardian's Email
Your answer
Profession/Place of Employment
Optional
Your answer
#2 Parent/Guardian's Name
Your answer
#2 Parent/Guardian's Cell Phone Number
Your answer
#2 Parent/ Guardian's Email
Your answer
Emergency Contact Name
Other than Parent or Guardian
Your answer
Emergency Contact Phone Number
Your answer
Emergency Contact Alternate Phone Number
Your answer
Please indicate if your child has had any challenges with the following.
Seizures
Vision
Hearing
AD/HD
Mobility
Asthma
Cardio Vascular
Diabetes
Allergies
Prescription Medication Information
Does your child use an inhaler?
It is the responsibility of the parent/guardian to ensure his/her child's inhaler is available at every HAC practice/meet/event.
Does your child have an EPI Pen?
It is the responsibility of the parent/guardian to ensure his/her child's EPI Pen is available at every HAC practice/meet/event.
Does your child carry any other prescription medication that will be taken during HAC practices/meets/events?
Your coach will connect with you to ensure we are meeting your child's needs.
Hamilton Aquatic Club Waivers
Please read each statement carefully. Should you not agree with any of the statements below please contact HAC Admin.
If at any time emergency medical treatment is necessary for my child, I give consent for treatment to be given. Every effort will be made to contact parent/guardian(s) and or emergency contacts.
The Hamilton Aquatic Club may decline a participant due to physical and/or verbal abuse towards our coaches, parents, and other swimmers.
Swim Ontario's Personal Information Protection and Electronic Documents Act requires the Hamilotn Aquatic Club to have on file a signed consent form for every family. By agreeing below you are giving consent to the HAC Administrative Team to enter required personal information on the Swim Direct Database. The information is not divulged to anyone without prior permission from the family and includes only the swimmer's name, address, date of birth and the parent/guardian name. By clicking I agree below you authorize the Hamilton Aquatic Club to share this information.
I understand that should my child withdrawal from the Hamilton Aquatic Club before the end of the season I have to give my notice in writing to the HAC Administration. It could take up to 10 business days to process my request to withdrawal from the Hamilton Aquatic Club. I understand that refunds with not be retroactive to the last swim practice but rather calculated based on the 40 week program structure and 12 month payment cycle. I understand that all volunteer commitments and meet fees will be pro-rated.
I agree to pay the monthly fee for my swimmer's level. I understand that it will be withdrawn from my bank account on the 15th of each month. Payments start on July 15th, 2017 and will be withdrawn monthly on the 15th of the month until June 15th, 2018.
I understand that each Hamilton Aquatic Club Family will be asked to volunteer a set number of sessions (depending on your level) during the year. Failure to participate will result in the full or partial payment of the bond agreement that I am agreeing to below ($60.00 per point) will be withdrawn from my account on June 1, 2018.
I agree to have the full or partial bond amount to the maximum of $960 (16 points) or minimum of $60 (1 points) withdrawn from my bank account on June 1st, 2018 should my family not make the volunteer commitment.
I agree to pay a $25.00 service fee on top of my monthly swim fee or other fees should any of my financial transactions returned to HAC as Non sufficient funds .
I understand and give consent that any photographs taken by the Hamilton Aquatic Club during practices, meets and events may appear on the HAC Website, Facebook page, and other HAC promotions.
I agree to have my Swimmer's Swim Ontario Fee (as indicated in the registration package) withdrawn from my bank account on September 1st, 2017. I realize my Swimmer can not start with the Hamilton Aquatic Club until this fee is paid.
I confirm that all of my son/daughter's information is correct to the best of my knowledge. I accept full responsibility and agree to all of the conditions HAC has presented me in this application. Please print the name of the person completing this form.
Your answer
A copy of your responses will be emailed to the address you provided.
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