Neshaminy CORE Swimming

Senior Elite USA

Registration & Fee Schedule

Brian Suter - Team Director

2017-2018 Season

September 18th or 2nd, 2017 – March 2018

Child’s Name: ______Birthdate: ______M/F_____

Address:______

City: ______State:______Zipcode: ______

Mother:______Phone Number: ______Cell Number: ______

Father: ______Phone Number: ______Cell Number: ______

Family Contact Email Address: ______

Medical Problems/Allergies: ______

Emergency Contact: ______Emergency Phone:______

Family Physician: ______Physician Phone: ______

Videotaping: During the course of practice, there may be opportunities for the coaching staff to videotape the athletes for correction purposes. Please indicate whether or not you will consent to the videotaping of your child for stroke correction:

______I consent ______I DO NOT consent

Pictures: During the course of the year we may post pictures of the athletes on our website. Please indicate whether or not you will consent to the posting of your child’s picture on the website:

______I consent ______I DO NOT consent

If you are new to the club, Please answer the following Questions:

If you swam for a club last year, which club did you compete for?______

Which family recommended us? ______

Family Name______

Fees

Program Amount Due Discount(*If paid by Sept. 14th ) Amt. Paid

Start Date- Sept. 18 Oct. 2 Sept. 18 Oct. 2

Senior CORE USA $760.00 $660.00 $684.00 $594.00 $______

USA Registration $80 $80 $80 $80

Volunteer Fee (Separate Check) $100.00 $100.00 $100 $100 $______

(One per family – Refundable upon completion

of SAL Volunteer Assignment)

Total Amount Due $940.00 $840.00 $864.00 $774.00 $______

*** Make check payable to CORE Swimming

*** No refunds will be given after October 9th. 50% of total amount due is refundable.

Partial Payment Plan

Start Date-Sept. 18 / Start Date-Oct. 2
50% (First day your child practices (Non-refundable)
+ USA REGISTRATION (Non-refundable)
+ Volunteer Check(*Will not be cashed unless
Volunteer obligation not met!(~First week of February) / $380.00(Check or Cash)
+$80 (Check or Cash)
+
$100.00 (Separate Check) / $330.00 (Check or Cash)
+$80 Check or Cash)
+
$100.00 (Separate Check)
25% By October 2nd / 190.00 (Check or Cash) / $165.00 (Check or Cash)
25% By November 2nd / 190.00 (Check or Cash) / $165.00 (Check or Cash)

This year’s Family cap is $1,100.00 (excluding volunteer fee, USA registration, SAL invitational fees)

If your family qualifies, Please complete the following chart (Once per family):

Child’s Name / Dues paid towards cap
1. / $
2. / $
3. / $
4. / $
Total-$