JOHNSON’S LANDING SWIM TEAM
Registration Form (Non-Refundable)
Last First Circle Age Birth date U SS Swimmer?
Name: ______M/F ______
______M/F ______
______M/F ______
______M/F ______
PLEASE PRINT CHILD’S NAME CLEARLY!
For engraving/monogramming purposes
Parents/Guardians: ______
Address: ______
City and Zip Code: ______
Phone: (Home) ______(Cell) ______
E-mail address: ______
Parents/Guardians:
We, the parents/guardians of the above participant(s), hereby give our approval for his or her participation in the above mentioned activity during the current season. We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. We do hereby release, absolve, and hold harmless the Johnson’s Landing Swim Team and the Johnson’s Landing Racquet and Swim Club Association, Inc., the organizers of the activities, sponsors, supervisors, and anyone connected with the program. In case of injury to my child, I hereby waive all claims against the organizers and supervisors of the activity. We likewise release from responsibility any person transporting our child to and from the activities.
Parents/Guardians Signature: ______
Date: ______
Cost: $85.00 for the first child; $55.00 for each additional child; $25.00 for 15-18 yr.olds.
Checks made payable to: Johnson’s Landing Swim Team
Return to: Cristy Young
3863 Sewell Mill Road, Marietta, GA.
(404) 626-1796