CSA Registration Form 2025
Fill out the below registration/release form for each family.
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Email *
Pool Name *
Swimmer LAST Name *
Swimmer FIRST Name *
Swimmer Birthdate  *
MM
/
DD
/
YYYY
HOME Street address *
HOME City *
HOME Zip Code *
Year Round Swimmer *
In consideration of allowing my child(ren) to participate in activities organized by the Community
Swim Association, I hereby, for my child(ren), myself, my heirs, executors, administrators, and
assigns, and anyone entitled to act on my behalf, or on behalf of my child, release and
discharge Community Swim Association, plus all sponsors, their representatives, and
successors, promoters, managers, directors, officials, agents, employees, and volunteers of
Community Swim Association events from any and all claims of injury or liabilities of any
kind, including any illness, injury, or damage suffered by my child(ren) as a result of participation
in or traveling to or from such events. I know that swimming and participation in these
activities is potentially hazardous, that my child(ren) should not enter any Community Swim
Association event unless he or she is medically able and properly trained, and I, as parent
or guardian, hereby assume all risks associated with participation in Community Swim
Association events including, but not limited to, falls, contact with other participants, the
effects of weather, and any and all other risks known or associated with swimming, all such
risks being known and appreciated by me. I hereby certify that my child is in good physical
condition and good health and able to participate in Community Swim Association events. *
Parent/Guardian Name
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