Coaching Information
Contact us at (780) 417-6439 or email at information@excelsynchroclub.com
Email address *
Excel Synchro Club - Edmonton, Beaumont, Leduc, and St.Albert
Swimmer Name (Last name, first name) *
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Please list any other sports and/ or number of years in synchro your child has done:
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Parent Last name, first name (main contact) *
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Parent Phone number (main contact) *
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Emergency Contact Name 1 *
Your answer
Emergency Contact Phone Number 1 *
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Emergency Contact Name 2
Your answer
Emergency Contact Phone Number 2
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Any health problems, allergies, use of medications or personal needs of which the coach should be aware: *
Your answer
Has your child suffered from any synchro or other sports injuries? *
If yes, have they recovered? *
If no, are they seeking active treatment for the injury? *
Any other information you would like Excel Synchro Coaches to know about your child?
Your answer
Collecting Information
The personal information collected in this form will be used only for the following purposes: Creating emergency contact lists with contact and health information for the coaches in charge of the programs; Creating emergency contact lists with contact and health information for appropriate chaperones for out of town competitions; creating the club roster with contact information for communication purposes.The information collected on this form is considered confidential by Excel Synchro Club and will be treated accordingly. Should you have questions about the the collection of personal information, please contact us.
Name of Person Completing this Form *
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ACCEPTANCE DECLARATION *
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