Delta Sungod Swim Club Season - Registration Form

Transcription

1 Season - Registration Form Parent s Address: All club correspondence goes out via . Club web login and password ed upon successful registration. Member Information: (Please complete in full) Last Name: Gender: Female Male First Name: Birth Date (mm/dd/yy): Address: Home Phone #: City: Postal Code: Parent #1: Occupation: Work Phone #: Parent #2: Occupation: Work Phone #: Emergency Contact: Relation: Phone #: BC Med #: Doctor: Phone #: Allergies, Medical Conditions or Learning Considerations: Previous Swimming Experience: _ School Attending: How did you hear about DSSC? Pool Banner Leisure Guide Easel Board Friend Website Newspaper Bulletin Board Other: Waiver If it should become necessary for my child, indicated above to receive emergency medical treatment, I hereby give my permission to the Delta Sungod Swim Club and its representatives to obtain medical assistance. In the event none of the individuals named above are able to be contacted, or the situation demands immediate action, I hereby give my consent to a licensed physician / emergency response team to administer the medical treatment deemed necessary, including hospitalization. I understand that every effort will be made to contact me or the specified alternate contacts in such event. I will not hold the Delta Sungod Swim Club or its representatives responsible for any injuries that may occur or treatment administered to my child. I consent to having personal information stored on the Team Unify Web Server. This server is located in Portland, Oregon, USA and is subject to national laws and guidelines. Mandatory Team suits Swimmers will be required to wear team suits for at all training and competition sessions unless specified by the Head Coach. Swimmers will be required to purchase at least 1 suit upon registration. Swimmers who are too small to fit the team suit (under size 20) will be required to purchase a straight navy blue suit. Termination of Swimming Should a member wish to discontinue swimming prior to the end of the season and wish reimbursement they must submit in writing their wish to discontinue 30 days prior to their next fee instalment. This declaration must be submitted to the Head Coach. Code of Conduct & Policy and Procedures All swimmers and their families upon registering with DSSC must abide by the code of conduct and the club s policy and procedures. This manual can be found on the club website under the Parent s Section.

2 Season Fee Schedule Group Age Times per Week Mini Dragons Learn To Swim Must be able to swim 10m unassisted and be comfortable in deep water. Novice Intro to Competitive CompDev Must register as competitive Developmental Age Group (DAG) Top Age Group (TAG) Regional NOTE: is the minimum req. to compete x/week 3x/week Days Attending (Please circle) Mon Wed Fri A) 5:00-6:00pm B) 6:00-7:00pm Sat 8:00-9:00am Mthly Fee $35 $60 Est. Meet Fee Monthly Cost $35 $ x/week Mon Wed Fri Sat $140 $10 $150 $40 $ x/week Mon Wed Fri Sat $210 $40 $ x/week Mon Wed Fri Sat Tues Thurs x/week 2xMon Wed Fri Sat 2xTues 2xThurs x/week Mon Wed Fri 3x/week Sat 4x/week $249 $40 $289 $277 $40 $317 $45 $135 $175 $40 $45 /$130 $135/$175 $175/$215 Subtotal Multisport Training Group Will be placed in either TAG/DAG based on ability. Entry at final discretion of Head Coach Based on Group Schedule 2 hours in pool per week max. (15min activation prior to practice not included in the 2 hours) $65 $65 DSSC Registration Fee Mandatory, Paid Seasonally 50% as of April 1 DSSC Team Suit DSSC Fundraising Fee Mandatory, Paid Seasonally, MD exempted DSSC Volunteer Commitment SwimBC Memberships Mandatory, Paid Seasonally 50% as of April 1 Per family $50 DSSC swimmers will be required to purchase a team suit. The cost is discounted 30%. Swimmers who cannot fit a club suit must purchase a solid navy blue suit. Competitive group swimmers will require 1 race suit, and 1 training suit. Novice/Regional DAG TAG Per Child Maximum Charge Mandatory, Paid Seasonally, MD exempted Non-Competitive 8 & Under (Competitive) 10 & Under (Competitive) (Competitive) 15 & Over (Competitive) $ Female $ Male $100 $150 $200 $100 $200 Families who register three or more siblings will receive 50% off the lowest monthly fee. This discount will be applied monthly so long as three siblings remain registered and the family is in good standing with the club. Payments can be made via credit card or direct debit. Void cheque may be attached to registration form. $38 $79 $99 $145 $187 Total Owed Today:

3 Season Registration Credit Card Authorization Form Account Holder s Name: Swimmer s Name: I, hereby grant the Delta Sungod Swim Club (DSSC) authorization to (Name as it appears on card) charge my : Visa MasterCard (select) for charges incurred for my child s swim program. First Month s Charges: Monthly Charges: Credit Card #: Expiration Security Code: Billing Address of Credit Card: I (card holder) hereby represent that I have the authority to execute this credit card authorization and agree that this Authorization will be effective on the date signed below. I understand and consent to the use of my credit card without my signature on the charge slip, that a photocopy or fax of this agreement will serve as an original and that 30 days written notice to the Head Coach in order to withdraw prior to the end of the season will be required in order for this authorization to be revoked. Cardholder Signature: _

4 Viewmont Ave, Victoria, BC V8Z 6L8. P: F: Club Name: Delta Sungod Swim Club Swimmer Name: Personal Information Consent Form Swim BC Registration Number: Please Read Carefully, Complete and sign this form. A Parent or Legal Guardian must sign for those swimmers under the age of 18. The Federal Personal Information Protection & Electronic Documents Act (and equivalent provincial legislation) requires that consent be obtained prior to the collection and use of all personal information. The personal information you provide to the Club from this registration will be used for the purposes reasonably associated with the swimming activities conducted by the Club. These purposes include national, provincial and event registration, insurance coverage, training and competition participation and competition result publication. Some of the information you provide will be passed on to Swimming/Natation Canada ( SNC ) and Swim BC, for purposes including association registration, insurance coverage and: a) Ensuring swimmers train and compete in an age appropriate environment; b) Establishing athlete eligibility for selection to swim teams; c) Establishing pertinent medical records d) Reporting non-identifying, demographic and participation statistics to funders, sponsors and other authorized 3rd parties; e) publishing athletes names, genders, ages, club affiliations on our web page or in results, news releases and ranking reports; and f) Making direct contact with swimmers as necessary for the operation of the Club, Swim BC and SNC. Additional personal information may be collected from time to time. Consent for the use of this personal information may be inferred where its uses are obvious and it has been voluntarily provided. Complete texts of the Privacy/Personal Information Policies (variously the Policy or Policies ) may be found at: for SNC at: and for Swim BC at: Should a swimmer wish to review their personal information held by the Club, Swim BC or SNC they must make a request to the appropriate organization pursuant to that organization s Policy. Further, swimmers may withdraw consent to use their personal information pursuant to the Policies. Such a withdrawal however, may require the cancellation of your membership with and suspension of your activities with the Club, Swim BC and SNC. All swimmers or their legal guardian must sign a copy of this form. I hereby consent to the collection and use of personal information as described above. Signature of Swimmer (18 or older) Or Parent / Guardian Date

5 Season Registration Parent Commitment Form Becoming a member of the Club involves more than arriving at the pool for practices. When considering the long-term progress of the athletes the parents are a key facet. They provide the framework of volunteers whose efforts are essential from local novice to high performance levels of sport at international events. The team network thrives when it is athlete centered, coach driven, and parent supported. Rose McDonald, Alumnus To operate Team Sungod we need all parents to give of their time. Other than the coaching staff, the entire organization is run by our parents on a volunteer basis. We need to acknowledge that in our modern society, everyone is truly very busy however; we need everyone to find a moment to lend a hand, share the load, and make our experience with the Team more fun for everyone. We are very appreciative of the dedicated parents who have given their time and energy on behalf of the Team. We understand the wide range of family commitments but with everyone s help we can ensure that the jobs we need done will not be overly demanding on any one family. The following are examples of volunteer opportunities: Welcome Back Party Swim Meets Dates to TBD Squad Fun Meets Team Photo coordinating Chocolate Bar Sales Bottle Drives Awards Night (Late September) Sign up for your activity at registration one activity is the minimum requirement to share the load Member Responsibility Be Involved As a member of Team Sungod your assistance will be needed in a variety of ways. Please read all member information including the Registration Package, Program Guide, and Policy and Procedure Guide. Ensure the following 5 forms are completed in full, signed and returned with your package: Registration Form Fee Schedule Credit Card Authorization Form Swim BC Personal Information Consent Form Parent Commitment Form Thank you for joining Team Sungod. We sincerely appreciate all the time, energy, and enthusiasm for sport provided by each of our volunteers. Your support is a key element in providing a positive experience for all participants. Parent Commitment 1. I understand that assistance is needed on a variety of activities including, but not limited to fundraising and social fitness 2. I understand that all members need to be available to help with any competition hosted by Team Sungod 3. I understand that at any competition, in particular meets, in which my child is entered that I am responsible for supporting my swimmer s entry by volunteering as an official. 4. I understand that if, due to other family conflicting events, I am unable to help at a competition in which my athlete is entered that I will contact the Head of Officials and then contribute equitable time in other ways in support of Team Sungod.