ONLINE Registration Form
New OLY Swimmers
2008 Long Course

Swimmer Information:
*Last Name:
*First Name:
*Middle Initial:  
Preferred Name (if different than first name):
*Birthday (MM-DD-YY):
*Age:
*Sex: Male Female

 
*Group Registering For: Technique         Junior
 Senior Red        Senior Blue
 College
*Season signing up for:
(Technique and Junior Only)		 Spring Only   Spring and Summer
*How did you find out about OLY? Swam for another team
 Name of former team
 A friend referred me
 Name of friend
 Looking for a team and heard about OLY
 Other or more than one -
 Please specify
 Current OLY Swimmer
 
Team Uniform Orders -
One team uniform will automatically be ordered for your swimmer in the size below.  If you wish to purchase additional uniforms, please list the number and size here.
 
*Tshirt size (Adult/Youth, S-XXL)
 
Contact Information:
Home Address:
*Street:
*City:
*State:
*Zip Code:
*Home Phone Number:
Father's Name:
Father's Place of Work:
Phone Number:
Cell Phone Number:
Mother's Name:
Mother's Place of Work:
Phone Number:
Cell Phone Number:
*Parent E-mail Address:
for newsletter, etc...
Parent E-mail Address:
any other person that would like the newsletter
Swimmer E-mail Address:
School Attending:
Grade:
Other Information:
*Grocery Coupon Commitment:  
 Choose one above

*Code of Conduct
 
By placing an X here I agree both my swimmer and I have read and will abide by the Code of Conduct
 


*Waiver
 		 By placing an X here I agree I have read and agree with the Waiver. 
*required information ***You must complete the emergency form for your registration to be accepted***

 


 Questions:  Please contact - Nancy Goins kagoins@aol.com  or 248-377-2407