spartans aquatic club

SPARTANS AQUATIC CLUB

Box 374
Lethbridge, Alberta T1J 3Y7
Phone: 403-329-4651
email: registration@spartansaquaticclub.com

Registration Form

SWIMMER INFORMATION
Swimmer Name
Birthdate
Gender
Phone
Email
Address
City
Province
Postal
Parent/Contact Name:
Name

Phone

Cell

Email
Alternate Emergency
Contact Name:
Name

Phone

Cell

Email
REGISTRATION
Group / Program
Swimming Schedule
Swimming Session

I understand that the primary method of communication is through email and the team website. It is my responsibility to update the team of any necessary changes.

I agree to pay fees according to the schedule.

Agree
Dated: Dec 14, 2017
MEDICAL INFORMATION
Alberta Health Care Number
Does the swimmer take any medications?
Does the swimmer know how to administer his / her own medications?
Medications
Allergies
Injuries
Other Conditions
(Braces, Contact Lenses, etc.)
Note: Medical information is confidential. This information sheet will be in the possession of the head coach at all times and will be available only to authorized individuals.