PUTNAM COUTNY YMCA SWIM TEAM REGISTRATION FORM
Name
Birth date Age (as of 12/01/11)
Address
Phone number
Parent’s Name
Email address
CONSENT FOR EMERGENCY TREATMENT
We, the parent’s
of give permission for medical treatment of our
child for illness or accident if we cannot be contacted.
*Parent/
Guardian signature
Does your child
have allergies or require special medications? YES NO
Please explain
Emergency
Contact Person (other than parents)
Name
Phone Number
We hereby agree
that the Putnam County YMCA Swim Team, its members, coaches, or officers shall
not be liable for any injury or loss which my child/ children may substain
while participating in activities of any kinds, whether sponsored by or under
supervision of the Putnam County YCMA Swim Team, its members, coaches,
officers, or designates of any kind from claim whatsoever.
Parent/ Guardian
Signature
Date
TERMS OF THE PUTNAM COUNTY YMCA SWIM TEAM
We hereby agree
that any inappropriate behavior by the swimmer, such as name calling, hitting,
biting, disrespecting coaches or another swimmer, will result in consequences.
The coach will give the swimmer 2 verbal warnings before being dismissed for
the rest of that days’ practice. If inappropriate behavior continues, other
discipline actions will be considered.
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