Wendell Waves Swim Team

Wendell Waves Swim Team

2017 Registration

Family Name: ______

Parent / Guardian Name / Parent / Guardian Name
Home address
Primary phone
Cell phone
Work phone
e-mail address
Emergency Contact
Name, phone & relationship

I understand thatWendell Waves uses their Yahoo group as the main method of communication. By not responding to the invitation to join their Yahoo group, I understand I will be missing vital information. It is my responsibility to respond to the invitation.

Please return this form by the registration meeting on Sunday, April 30, 2017, along with the registration fee and $12.00 for each end-of-year plaque (if first time team members) to:

Wendell Waves Swim Team

Attn: Paige Perry

513 Lemon Pepper Place

Wendell, NC 27591

Make checks payable to: Wendell Swim Club

In the memo section, please list 1st names of swimmers you are paying for.

Any outstanding t-shirt payments must be paid before shirt delivery.

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

Swimmer name: ______

First Last

DOB: ______Age: ______Gender: ______

Swimming Level (circle one): BeginnerIntermediateAdvanced

First year with Wendell Waves: YesorNo

Previous swim team experience? If so, how many years? ______

Please list any allergies and/or medical conditions that coaches may need to know about for this swimmer:

______

T-shirt Order Information:

Each swimmer will receive a free t-shirt if registration is returned by deadline. Additional t-shirts can be ordered for a price. Adult 2XL & 3XL may be an additional fee.

Name / Size
Child S, M, L, XL
Adult S, M, L, XL / Quantity / Amount Due

Swim Team Committee use only:

Registration / Date paid / Plaque / Quantity
Check # / Name(s)
Date paid
T-shirt / Date paid / Check #
Check#
Date delivered / Swim Cap / Date delivered

2017 Registration Form