*Last Name
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*First Name
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*Middle Initial
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Preferred Name (If different than first name
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*Birthday (MM-DD-YY)
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*Age
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| *Sex
MaleFemale |
*Group registering for
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*How did you find out about OLY?
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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.
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*T-shirt Size
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*Street Address
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*City
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*State
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*Zip Code
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*Home Phone Number
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Father's Name
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Father's Place of Work
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Father's Phone Number
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Father's Cell Phone Number
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Mother's Name
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Mothers Place of Work
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Mother's Phone Number
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Mother's Cell Phone Number
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*Parent E-mail Address (For Newsletter, etc.)
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Parent E-mail Address (For another person who wants newsletter, etc.)
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Swimmer's E-mail Address
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School Attending
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Grade
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*Grocery/SCRIP Commitment
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*Code of Conduct (By checking this box I agree that both my swimmer and I have read and will abide by the Code of Conduct) |
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*Waiver (By checking this box I agree I have read and agree to the waiver) |
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