2017 AIS Piranhas Swim Team Registration Term 3
We are looking forward to welcoming Piranhas swimmers and parents back for Term 3 2017

Please note that PIRANHAS TERM 3 swimming classes WILL COMMENCE ON TUESDAY 25th OF JULY and WILL END ON FRIDAY 29th OF SEPTEMBER 2017.

If your child is a new swimmer, please contact the head coach (Coach Audrey) by emailing piranhas.headcoach@ais-indonesia.com to arrange an assessment time, in order to determine which training group your child should join.

To register, please follow the steps below:

1. Complete this registration form
2. Swimmers will receive an invoice which will be sent by email.
3. All payments are to be made into the AIS school account.
4. Email proof of payment to remy.junsay@ais-indonesia.com

Swimmer's Full Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Mother's Name
Your answer
Mother's Phone Number
Your answer
Father's Phone Number
Your answer
Primary Email Contact Address
Your answer
In Case of Emergency, please contact (other than yourself)
Your answer
Emergency Contact Number
Your answer
Swim Squad Practice Groups and Costs
Liability Release
I hereby fully release and discharge AIS Piranhas Swim Squad, its coaches, organisers, and all other related parties (collectively "The Released Parties"), unconditionally from all liabilities whatsoever arising from my child's/ward's participation in the above mentioned Swim Squad, including any and all incidental activities related to it. I hereby indemnify and hold *The Released Parties harmless from any suit, claim or damage, including all monetary damages, medical expenses, attorney's fees, and any all other claims which may arise as a result of any in jury or accident occurring as a result of my child's/ward's participation. In the event of an accident or injury, I understand that the AIS Piranhas Swim Squad coaches and organisers will make all reasonable efforts to immediately inform me. I will be responsible for providing updated contact information to the Swim Squad organisers. In case of emergency and I can't be contacted, I authorise any representative of the AIS Piranhas Swim Squad to act on my behalf to obtain medical care on behalf of my child/ward. I agree to pay all costs and expenses of any such medical treatment and will promptly reimburse the Swim Squad organisers for all related incurred costs, without exception and upon demand.
Required
Apply for ID Pass and Car Pass
Driver's Name
Your answer
Car Registration Number
Your answer
Type of Car (i.e Toyota, Honda, Nissan, etc)
Your answer
Colour of Car
Your answer
ID Pass Name (Please email copy of KTP/KITAS and ID size coloured picture to remy.junsay@ais-indonesia.com
Your answer
Submit
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