Important 2015 Date!!! Our home swim meet The Ukiah Dolphins Soroptimist Swim Meet is the weekend of July 24 th.

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Chloe Jasmin Daniel
8 years ago
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1 Thank yu fr yur interest in jining the Ukiah Dlphins! Here is ur registratin packet. Please read and fllw these imprtant guidelines as yu cmplete yur packet: Fill ut and turn in every part f the packet (d nt mail). If yu have any questins abut hw t cmplete a frm, please d nt hesitate t cntact ur membership chairpersn, Rbin Dlan. (rbindlan@sbcglbal.net ) Make sure t enclse all fees with registratin frms. New swimmers shuld turn in tw checks. One check fr $80 written t Ukiah Dlphins. (Dues are nt prrated.) One check written t Pacific Swimming fr $73. One USA Swimming registratin frm is required per swimmer. Yur membership with USA swimming prvides imprtant insurance cverage when he r she is in the pl as well as during swim meets. USA Water Pl: All water pl players must have a minimum f a silver membership with USA Water Pl. That registratin can nly be dne nline: Cmmunicatin is essential! We require a minimum f ne address per family. We wuld prefer t have addresses fr bth parents as well as fr the swimmer if they have ne. We wuld als like yu t like ur Facebk page if yu are have an accunt ( t keep updated. As life gets busy, deadlines t sign up fr meets, r getting fun events n the calendar can fall thrugh the cracks. We d ur best t remind ur families via and Facebk. Cmmunity Outreach/ Schlarships. Ukiah Dlphins ffers schlarships fr swimmers and water pl players wh participate in the prgram year-arund. Pacific Swimming ffers a reduced membership fee fr thse wh qualify. Shuld a swimmer qualify fr fd stamps r free lunch prgram, they just need t shw prf with their Pacific Swimming applicatin and their membership fee will be $5. The Ukiah Dlphins Bard, President, Heath Dlan First Vice-President, Shelley Barrett Secnd Vice-President, Jay Epstein Treasurer, Amanda Hlstine bahlstine@yah.cm Crrespnding Secretary, Casey Mrtier Recrding Secretary, Swim Representative, Sue Passalacqua Pl Representative, Kriket Hatcher Imprtant 2015 Date!!! Our hme swim meet The Ukiah Dlphins Srptimist Swim Meet is the weekend f July 24 th.

2 Ukiah Dlphins Member Registratin Please print CLEARLY. Please prvide ALL infrmatin requested. Swimmer/ Pl Player Infrmatin First Middle Last Nickname M/F Birthdate Mailing Address City/ Zip Hme Phne Address Address Family Infrmatin Child lives with: Mther First & Last Name Cell Phne Occupatin Interests/ Skills Father First & Last Name Cell Phne Occupatin Interests/ Skills Tday s Date

3 Ukiah Dlphins Medical Release Frm Please print CLEARLY. Please prvide ALL infrmatin requested. Family Dctr Phne Number Insurance Cmpany Grup/ Member Number Emergency Cntact (ther than Parent/ Guardian) Relatinship Phne Number Swimmer/ Pl Player #1 Name D they use an inhaler?* Is he/she allergic t any medicatins r substances? Please list allergies Current medicatins Other medical cncerns the cach shuld knw abut Swimmer/ Pl Player #2 Name D they use an inhaler?* Is he/she allergic t any medicatins r substances? Please list allergies Current medicatins Other medical cncerns the cach shuld knw abut Swimmer/ Pl Player #3 Name D they use an inhaler?* Is he/she allergic t any medicatins r substances? Please list allergies Current medicatins Other medical cncerns the cach shuld knw abut * If yur swimmer/ water pl player uses an inhaler, it is yur respnsibility t have it n hand at every practice. Medical Waiver/ Authrizatin I certify that the abve names swimmer(s) and/ r water pl player(s) is/are medically and physically able t participate in swim r water pl training and/r cmpetitin. I hereby waive all claims fr injury r liability f any kind fr the abve mentined swimmer(s)/ water pl player(s), and in the case f an accident r injury in any way resulting, directly r indirectly, frm participatin in such prgrams, hld blameless frm any liability Ukiah Dlphins, its fficers, caches, managers r any ther persn r persns in any way cnnected r assciated with this prgram. Furthermre, in the case f emergency medical attentin that may be necessary, I authrize the adult caches t act n my behalf, accrding t their best judgment and ability. I give my permissin fr my child/ children t swim and/r play water pl with Ukiah Dlphins. Parent/ Guardian Signature Date Tday s Date

4 Ukiah Dlphins Vlunteer Plicy The Ukiah Dlphins Swim & Water Pl Club is a vlunteer rganizatin. We simply cannt run the rganizatin withut the help f all f the families f the swimmers and water pl players wh participate in the prgram. Unlike ALL ther swim and water pl teams in ur area, we d nt keep track f vlunteer hurs, r charge a fee fr thse wh dn t pitch in t help. In rder t cntinue being relaxed with the vlunteerism f ur team in this way, we need t rely n everyne t step up and pitch in where and as ften as they can. We need lts f help. These are sme f the vlunteer pprtunities fr yu t cnsider: Pulling tarps n and ff the pl, and putting equipment away after all practices. Chairing r being n the cmmittee t rganize the Hawaii vacatin raffle fundraiser. Chairing r being n the Blue Lakes Swim Cmmittee. Becme trained t be an n-deck fficial at swim meets. Our team is required t prvide a certain number f fficials at each meet based n hw many f ur swimmers are entered in the meet. All families are required t help (and dnate fd items) with ur annual swim meet held n the weekend f July 25 th. We need peple t step up t learn key psitins in the planning and executin f the meet. At ur hme meet, we d nt need ur families t vlunteer t be timers. Other teams prvide them. Hwever, when we are at ther meets, we are assigned a lane and need t prvide timers. Please vlunteer t time at the next meet yu g t. We have many bard psitins available. Even if yur child des nt participate year-arund, there are many jbs that wuld be gd fr yu. Please cntact bard members with any questins abut any f the vlunteering pprtunities. I acknwledge that I have read and understand that Ukiah Dlphins is a vlunteer rganizatin. Fr my child t participate, my help n and arund the pl deck, and with events is abslutely necessary. I agree t d my part in helping Ukiah Dlphins cntinue t prvide a great swim and water pl prgram t ur cmmunity. These are skills that I believe will cme in handy t help ut Ukiah Dlphins (i.e. gd with QuickBks, cmputer wrk, planning events etc): Print Name: Signature: Date:

5 Ukiah Dlphins Dues Payment Plicy T participate as a swimmer r water pl player with Ukiah Dlphins csts $80 per mnth. The mnthly dues are nt prrated. Swimmers must submit payment t the dues bx at the pl during the first practice they attend each mnth. If payment has nt been received by the third practice they attend, they will n lnger be allwed t participate in practice r cmpete in swim meets until it has been paid. Water pl players will submit their dues in entirety fr each water pl seasn, generally cnsisting f apprximately tw mnths. The caches determine the length f each seasn in advance and will annunce the ttal amunt f dues wed. In additin, there will be a predetermined turnament fee assessed at the beginning f each seasn fr all players. Shuld payment nt be received by the end f the first week f the water pl seasn, the player will nt be able t participate in practice r in any turnaments until payment has been received. Swimmers wh have paid their mnthly dues are welcme t participate in water pl fr free, and vice versa. Checks shuld be written t Ukiah Dlphins and delivered directly t the pl int the dues bx r handed t a Ukiah Dlphins cach r bard member. I acknwledge that I have read, understd, and agreed t the abve payment plicy. Print Name: Signature: Tday s Date

SCHOLARSHIP APPLICATION

Assciatin f State Dam Safety Officials UNDERGRADUATE SCHOLARSHIP APPLICATION SUBMIT APPLICATION AND ATTACHMENTS POSTMARKED BY MARCH 31, 2016 TO: Assciatin f State Dam Safety Officials 239 S. Limestne Lexingtn,