SWIMMER REGISTRATION

Parent Information
Parent Name (1)
First Last
Work / Cell
Email
Parent Name (2)
First Last
Work / Cell
Email
Parent's Shirt Size
*$20 when paid with registration *Adult sizes only
Address
Street Address City State ZIP Code
Swimmer Information
Child 1
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/21
Please enter a number from 5 to 18.
*please enter number between 5-18
Gender
- Male
- Female
Level
*Level to be determined by coaches during the first week of practice. Sharks must be able to swim 50 yards, consistently, and have knowledge of at least TWO strokes. Jr Sharks must be able to swim 25 yards, consistently, and have knowledge of at least ONE stroke.
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
Child 2
- + Add Child
Child 2
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/21
Please enter a number from 5 to 18.
*please enter number between 5-18
Gender
- Male
- Female
Level
Choose one from the drop down
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
Child 3
- + Add Child
Child 3
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/21
Please enter a number from 5 to 18.
*please enter number between 5-18
Gender
- Male
- Female
Level
Choose one from the drop down
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
Child 4
- + Add Child
Child 4
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/21
Please enter a number from 0 to 25.
*please enter number between 5-18
Gender
- Male
- Female
Level
Choose one from the drop down
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
Child 5
- + Add Child
Child 5
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/21
Please enter a number from 0 to 25.
*please enter number between 5-18
Gender
- Male
- Female
Level
Choose one from the drop down
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
Child 6
- + Add Child
Child 6
First Last
Date of Birth
Date Format: MM slash DD slash YYYY
Age as of date 6/1/20
Please enter a number from 0 to 25.
Gender
- Male
- Female
Level
Choose one from the drop down
Swimmer Shirt Size
Guaranteed if registering before May 10
Youth Shirt Size Selection
Guaranteed if registering before May 10
Adult Shirt Size Selection
Guaranteed if registering before May 10
LIABILITY WAIVER & MEDICAL CONSENT
I, the parent/guardian of the above-named child(ren), certify that all of the above information is correct. I hereby give my approval for my child’s/children’s participation as a swimmer on the Farmington Sharks Swim Team, and their participation in any and all Farmington Sharks Swim Team activities. I understand that swimming is an action sport carrying the risk of significant personal injury, and do hereby waive, release, absolve, indemnify and agree to hold harmless the Farmington Sharks Swim Team, its Coaches, its Board of Directors, sponsors and volunteers while my child participates in practices and meets, of any claim arising out of any injury to my child(ren). Should an accident or injury occur, I hereby authorize the above named swimmer(s) to be treated by qualified medical personnel and/or be transported to an emergency medical facility.
Parent/Guardian Name Printed:*
First Last
Parent/Guardian Signature and Date:*
COVID-19 LIABILITY WAIVER
Covid 19 Liability Waiver 1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings regarding COVID-19, and further agree to follow any oral instructions or directions given by Farmington Sharks Swim Team, or the employees, representatives or agents of Farmington Sharks Swim Team. 2. ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activity regarding COVID-19, acknowledge the contagious nature of COVID-19 and understand that CDC and public health authorities recommend the practice of social distancing, and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Farmington Sharks Swim Team for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of Farmington Sharks Swim Team, whether caused by the fault of myself, my family, Farmington Sharks Swim Team or other third parties. I acknowledge that Farmington Sharks Swim Team has followed all local and state requirements regarding the coronavirus pandemic to reduce the spread of COVID-19. I acknowledge that Farmington Sharks Swim Team cannot guarantee that I will not become infected with COVID-19.
Parent/Guardian Name Printed:*
First Last
Parent/Guardian Signature and Date:*
PHOTO RELEASE WAIVER
Photo Release: The Farmington Sharks Swim Team reserves the right to photograph participants in the Swim Team program for potential future use. All photos remain the property of the Farmington Sharks Swim Team and may be used on promotional materials including the Farmington Sharks Swim Team website or other purposed determined by the staff and Board of the Farmington Sharks Swim Team. The name of a minor will never be associated with the photographs in a public forum.
Select one below*
- I give permission for my child(ren) to be photographed
- I do NOT give permission for my child(ren) to be photographed
Signature*
Printed Name*
First Last
Trial Period: The Farmington Sharks Swim Team offers a one week trial period. New swimmers are encouraged to try our practices to see if they are a good fit for you and your family. If you are not completely satisfied after one week, your swim team registration and fundraising fees (if applicable) will be fully refunded. No other refunds will be considered. This includes refunds for injuries, vacations, jobs, etc.
Today's Date
Date Format: MM slash DD slash YYYY
Total
$0.00

Get in Touch

Email
swimteamfarmington@gmail.com
Address
1053 Helmsdale Drive Forest VA 24551

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SWIMMER REGISTRATION

Parent Information

Swimmer Information

LIABILITY WAIVER & MEDICAL CONSENT

COVID-19 LIABILITY WAIVER

PHOTO RELEASE WAIVER