Cottonwood Clippers Swim Team Registration 2023, OPENS MAY 1st

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Cottonwood Clippers Swim Team Registration 2023, OPENS MAY 1st

Interested swimmers need to complete registration form. ONE form needs to be completed for EACH swimmer you are registering.

Keep In Touch:
Facebook: @Cottonwood Clippers Swim Team
Email us at: ctwdclippers@gmail.com
Website: www.cottonwoodclippers.webs.com

Pool location: 150 S 6th Street in Cottonwood
Directly across from Cottonwood Recreation Center (enter on Brian Mickelsen Parkway)

Important Dates:

May 11th from 5:00-6:30pm for In-Person Registration Night at the Cottonwood Rec Center

May 30th is the first day of practice (Tuesday after Memorial Day).

May 31st at 6:30pm for a Clippers parent meeting at the Cottonwood Rec Center

Swimmer's LAST Name:

Swimmer's FIRST Name:

Date of Birth (use numerical dating 00/00/0000):

Swimmer's phone number if applicable:

May we send group text messages to the swimmer's number?

Yes

Clear selection

Gender:

Male

Female

Has your swimmer swam on a club or school team before? How many years?

First and last name of primary contact:

Address, city, state, zip code:

Primary contact email address:

May we use the above email to send group emails?

Yes

Clear selection

Primary contact phone number:

May we send group text messages to this number?

Yes

Clear selection

Would you, the parent/guardian of a swimmer, be interested and willing to volunteer at our local Clippers events?

Yes

Clear selection

Primary contact employer:

Would your employer like information about supporting the swim team as a banner sponsor?

Yes

Clear selection

Secondary contact name:

Secondary address if different from primary address:

Secondary email address:

May we use the above secondary email to send group emails?

Yes

Clear selection

Secondary phone number:

May we use the above secondary phone number to send group texts?

Yes

Clear selection

Secondary contact's employer:

Would the secondary employer be interested in receiving information about becoming a swim team banner sponsor?

Yes

Clear selection

Emergency contact#1 name:

Emergency contact#1 relationship to swimmer:

Emergency contact#1 phone number:

Emergency contact#2 name:

Emergency contact#2 relationship to swimmer:

Emergency contact#2 phone number:

Swimmer's physician name:

Physician phone:

Has your child experienced any of the following:

Asthma/wheezing?

Seizures?

Diabetic?

Bleeding disorder?

Orthopedic problem?

Vision/hearing?

Allergies?

Other:

Please elaborate on any of the medical conditions marked above:

Read and electronically sign below: Consent for Emergency Care: BE IT KNOWN that I, the undersigned parent or guardian of the swimmer named above, do hereby give and grant unto any medical doctor or hospital my consent and authorization to render such aid, treatment or care to said swimmer as in the judgment of said doctor or hospital as may be required, on an emergency basis, in the event said swimmer should be injured or stricken ill. IT IS HEREBY UNDERSTOOD that the consent and authorization hereby given and granted are continuing and are intended by me to extend through the current swim season. IT IS FURTHER UNDERSTOOD that any expenses incurred will be paid by insurance or the parent/guardian of said swimmer.

Date elelctronically signed:

YYYY

NO refunds will be issued after the first team practice. Initial below:

Please help us by letting us know how to best promote our team by indicating how you heard about Cottonwood Clippers:

If a friend or family referred you to our team, and you consent to us thanking them, please indicate their full name below:

Please read and electronically sign below:

Please read and electronically sign below:

Please read and electronically initial below: *

Please check which method of payment you will be paying by below. We will be accepting cash, checks, and Zelle at Registration Night ONLY. NO CREDIT CARDS WILL BE ACCEPTED. *

ZELLE: (ccswimteam23@gmail.com) *Our preferred method. Please add your swimmers name in the ZELLE memo*

Check mailed in

Cash or check at Registration Night

I understand that all registration fees are due before a swimmer may begin participating in practice unless prior arrangements have been made with the head coach.

Please electronically sign below:

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms