West Austin Athletic Club - Rec Swim Team Registration
(If you have any problems registering online - please call Becky or Susan at 263-4282)
Spring Rec Swim Team Registration Form
*
Parents Name
*
Primary Phone
*
Email Address
Contact and Swimmer Information
This information is required only if this is the first West Austin form you have completed in 2012.
Address
City
Zipcode
Additional Contact Phone Numbers - Home, work, cell, mom, dad
Doctor to call in an emergency
List any medical information that the swim staff should know including allegies, medications, disorders, seizures, asthma, anything you think important
Do you give permission for your child to go down the slide or off the diving boards
Yes
No
Swimmer 1
Swimmers First Name
Last Name
Date of Birth
Gender
Past Swim Team Experience
Winter Rec Swim Team Jan 9 - Mar 8
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Winter Preferred Practice Times:
MW 3:45-4:45 TTh 5-6
MW 6:30-7:30 TTh 5-6 9 & Older
Spring Rec Swim Team March 19-April 27
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Spring Preferred Practice Times:
M-Th 3:45-4:30 8 & Younger
M-Th 4:30-5:30 10 & Younger
M-Th 5:30-6:30 9 & Older
Swimmer 2
Swimmers First Name
Last Name
Date of Birth
Gender
Past Swim Team Experience
Winter Rec Swim Team Jan 9 - Mar 8
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Winter Preferred Practice Times:
MW 3:45-4:45 TTh 5-6
MW 6:30-7:30 TTh 5-6 9 & Older
Spring Rec Swim Team March 19-April 27
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Spring Preferred Practice Times:
M-Th 3:45-4:30 8 & Younger
M-Th 4:30-5:30 10 & Younger
M-Th 5:30-6:30 9 & Older
Swimmer 3
Swimmers First Name
Last Name
Date of Birth
Gender
Past Swim Team Experience
Winter Rec Swim Team Jan 9 - Mar 8
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Winter Preferred Practice Times:
MW 3:45-4:45 TTh 5-6
MW 6:30-7:30 TTh 5-6 9 & Older
Spring Rec Swim Team March 19-April 27
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Spring Preferred Practice Times:
M-Th 3:45-4:30 8 & Younger
M-Th 4:30-5:30 10 & Younger
M-Th 5:30-6:30 9 & Older
Swimmer 4
Swimmers First Name
Last Name
Date of Birth
Gender
Past Swim Team Experience
Winter Rec Swim Team Jan 9 - Mar 8
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Winter Preferred Practice Times:
MW 3:45-4:45 TTh 5-6
MW 6:30-7:30 TTh 5-6 9 & Older
Spring Rec Swim Team March 19-April 27
3-5 Days/week (Non-members) $135
3-5 Days/week (Members) $121.50
1-2 Days/week (Non-members) $110
1-2 Days/week (Members) $103.50
Spring Preferred Practice Times:
M-Th 3:45-4:30 8 & Younger
M-Th 4:30-5:30 10 & Younger
M-Th 5:30-6:30 9 & Older
*
Indicates Response Required