Richland WAVES Registration Form AWS
Richland WAVES Registration Form Please list the names of the swimmers in your household Swimmer 1 __________________________________________ First MI Last Swimmer 2 ___________________________________________ First MI Last Swimmer 3 ___________________________________________ First MI Last
M/D/Y Date of Birth Sex
FREE* T-shirt Age as Circle of June Size 1st
__/__/__
F M
YS YM YL AS AM AL
__/__/__
F M
YS YM YL AS AM AL
__/__/__
F M
YS YM YL AS AM AL
Fees ____ $135 by April 23 ____ $160 after April 23 ____ $30 non-resident fee (per Family) ____ $125 by April 23 ____ $150 after April 23 ____ $110 by April 23 ____ $135 after April 23
**NEW RULE** New WAVES team swimmers and any swimmer not registered last year must present the original birth certificate or passport for our review and provide a photocopy for the Gwinnett County Swim League files. Parent(s) Name(s): Address:
Subdivision Name
City/Zip Main Contact Phone # _____________________________
O Home O Mom mobile O Dad mobile O Other –who?
_____________________________
O Home O Mom mobile O Dad mobile O Other – who?
Email Address-Primary
O Other
_____________________________
O Home O Mom mobile O Dad mobile O Other – who?
Email –Secondary
_______________________________________________________
O Mother’s O Father’s O Swimmer Emergency Contact:
O Richland Third Phone #
Second Phone #
Name
_____________________________________________ O Mother’s O Father’s O Swimmer Relationship
Emergency Contact Phone #
Emergency Cell Phone #
PLEASE NOTE: You must pay your current R.H.O.A. dues to be eligible for Swim Team. Refund Policy: No refunds will be given after 5 days past the first scheduled swim meet of 2017. Refunds prior to the refund request deadline of 5 days past the first scheduled swim meet will be given in full minus a $15 administrative fee per swimmer and minus $30 non-resident fee if applicable. No refunds on swimsuits or other apparel or equipment.
___________________________________________ Parent/Guardian Signature
__________________ Date
**********************************Do Not Write Below This Line*********************************** Accounting:
Registration fees:
$___________________
Non-resident fee
$___________________
Spirit wear fees
$___________________
TOTAL Paid
$_____________Due_______ O Cash O EFT O Check #__________
* Free T shirt for swimmers who register by April 23rd
M/D/Y Date of Birth Sex
FREE* T-shirt Age as Circle of June Size 1st
__/__/__
F M
YS YM YL AS AM AL
__/__/__
F M
YS YM YL AS AM AL
__/__/__
F M
YS YM YL AS AM AL
Fees ____ $135 by April 23 ____ $160 after April 23 ____ $30 non-resident fee (per Family) ____ $125 by April 23 ____ $150 after April 23 ____ $110 by April 23 ____ $135 after April 23
**NEW RULE** New WAVES team swimmers and any swimmer not registered last year must present the original birth certificate or passport for our review and provide a photocopy for the Gwinnett County Swim League files. Parent(s) Name(s): Address:
Subdivision Name
City/Zip Main Contact Phone # _____________________________
O Home O Mom mobile O Dad mobile O Other –who?
_____________________________
O Home O Mom mobile O Dad mobile O Other – who?
Email Address-Primary
O Other
_____________________________
O Home O Mom mobile O Dad mobile O Other – who?
Email –Secondary
_______________________________________________________
O Mother’s O Father’s O Swimmer Emergency Contact:
O Richland Third Phone #
Second Phone #
Name
_____________________________________________ O Mother’s O Father’s O Swimmer Relationship
Emergency Contact Phone #
Emergency Cell Phone #
PLEASE NOTE: You must pay your current R.H.O.A. dues to be eligible for Swim Team. Refund Policy: No refunds will be given after 5 days past the first scheduled swim meet of 2017. Refunds prior to the refund request deadline of 5 days past the first scheduled swim meet will be given in full minus a $15 administrative fee per swimmer and minus $30 non-resident fee if applicable. No refunds on swimsuits or other apparel or equipment.
___________________________________________ Parent/Guardian Signature
__________________ Date
**********************************Do Not Write Below This Line*********************************** Accounting:
Registration fees:
$___________________
Non-resident fee
$___________________
Spirit wear fees
$___________________
TOTAL Paid
$_____________Due_______ O Cash O EFT O Check #__________
* Free T shirt for swimmers who register by April 23rd
