Jonestown Sharks

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Jonestown Sharks

2020 Swim Team Registration

Swimmer Name *

Swimmer Age *

Swimmer Date of Birth *

YYYY

Swimmer Health Issues *

Additional Swimmers? *

Yes

Parents Name *

Complete Address *

Mother's Preferred Phone Number *

Father's Preferred Phone Number *

Email address (may also include swimmer's email) *

My child/children has/have my permission to participate on the Jonestown Swim Team. He/she is in good physical condition. In case of illness or injury, I authorize the calling of the rescue squad and/or transportation to the below medical facility for medical treatment. *

Wake Forest Baptist/Brenner's Children Hospital

Novant Health Forsyth Medical Center

Other:

In the event my child is transported to the above chosen facility either by rescue squad or other transportation for medical treatment, I understand and agree Jonestown Swim Club is not held liable or responsible for expenses. *

I understand and agree

Required

I understand and agree that the best possible supervision will be provided for my child/children but the Jonestown Swim Club and Greater Forsyth Swim League are not responsible for any accidents which may occur while participating in swim team events. *

I understand and agree

Required

Parent signature (Typed name constitutes signature)

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