SWIM TEAM FORM 2017
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2017 WRAC SWIM TEAM CONTACT INFORMATION
Updated 6/2/17
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Father's First & Last Name:Mother's First & Last Name:Emergency Contact:
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Address:Address:Emg. #:
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(____) _____-________
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City:City:Relationship:
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Email:Email:
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Best Ph #: (_____) _____-_______Best Ph #: (_____) _____-_______
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Meet Crew Commitment (parent/adult):
June 29: July 20: July 29 - Championships:
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Announcer
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Starter
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Athlete Guide
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Timer
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Stroke & Turn Judge
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Runner
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End of season Party Coordinator.
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Swimmer #1:Swimmer #2:Swimmer #3:
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Name:Name:Name:
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Date of Birth: _____/______/______Date of Birth: _____/______/______Date of Birth: _____/______/______
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AGE: _________________AGE: _________________AGE: _________________
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#1-Beginner / 8:30 am _____
#1-Beginner / 8:30 am _____
#1-Beginner / 8:30 am _____
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#2-Intermediate / 7:45 am ______
#2-Intermediate / 7:45 am ______
#2-Intermediate / 7:45 am ______
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#3 Advanced / 7:00 am _____
#3 Advanced / 7:00 am _____
#3 Advanced / 7:00 am _____
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Critical Health Information:Critical Health Information:Critical Health Information:
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REGISTRATION FEE PER SWIMMER (subject to wsst):
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STANDARD FEE WITH completion of Meet Crew Commitment section above:
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WRAC Member: $119WRAC Member: $119WRAC Member: $119
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Non-Member: $145Non-Member: $145Non-Member: $145
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"OPT OUT" FEE required WITHOUT completion of Meet Crew Committment section above:
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Member Opt Out: $159Member Opt Out: $159Member Opt Out: $159
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Non-Member: $190Non-Member: $190Non-Member: $190
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Swim Suit (Optional): $32 Swim Suit (Optional): $32 Swim Suit (Optional): $32
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Gender: Girl ____ Boy ____Gender: Girl ____ Boy ____Gender: Girl ____ Boy ____
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Size: 22, 24, 26, 28, 30, 32, 34
Size: 22, 24, 26, 28, 30, 32, 34Size: 22, 24, 26, 28, 30, 32, 34
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For WRAC Staff only:
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Date: ___/___/___Amount: $__________
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__ Check #______; __ Cash __ccStaff: ______________
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see backside for Behavior Code
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WVSSL INFORMATION AND BEHAVIOR CODE:
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Swimmers and parents will submit to the authority of WVSSL Board members, coaches and any on duty lifeguards when involved in any WVSSL event. Violation may result in immediate expulsion from the event. WVSSL Board members, coaches and parents will work to promote good sportsmanship and teamwork amongst WVSSL participants. WVSSL Board members, team administrators and coaches may determine what behaviors challenge good sportsmanship and teamwork. Swimmers and parents will not behave in ways that interfere with the participation of, or threaten the safety of, any other person during WVSSL events. WVSSL Board members and coaches may determine what constitutes interfering or threatening behavior. During WVSSL events, swimmers may not use or possess tobacco. During WVSSL events, no person may use or possess illegal drugs; illegally use prescription drugs; use non-prescription drugs or herbal remedies for purposes other than their published indications at other than the recommended dosages.
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Certification: I declare my child is eligible to participate in the WVSSL and that the age and date of birth provided are correct. My child and I have read and understand the above. I authorize the agents of the Wenatchee Racquet & Athletic Club Swim Team Coaches and the Wenatchee Valley Summer Swim League to act on my behalf in a medical emergency concerning the swimmer listed above.
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Parents, please initial your consent here _____.
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DATE: ____/_____/2017
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