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Registration &

Membership Application

2010-2011 www.Southwesternaquaticsteam.org

Swim now…Breathe later!

8433 FM 1464 Suite L-160 Email: swat.membership@swimwithswat.org Richmond, TX 77407-6400 www.swimwithswat.org

( 281/858-7946

( 281/858-7946

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WELCOME! Southwestern Aquatics Team (SWAT) is a USA Coach managed competitive swimming program.

Our main objective is to teach and offer a safe and fun environment for all students in both competitive and noncompetitive swimming. We focus on Technique, Stroke development, Speed, Strength & Conditioning training.

Our goal is to build strong competitive swimmers with strong character and grow the sport of swimming in our community. All members are welcome to be involved in team activities.

PLEASE READ ALL INFORMATION CAREFULY.

SWAT is a USA Swimming team that offers Competitive and Non-competitive swimming. Our progressive multi- level training program is designed to meet each individual swimmer’s ability and based on the swimmer’s commitment to their individual goal.

SWAT focuses on developing sound training habits and improving swimming technique and stroke mechanics for beginning swimmers. Experience age group swimmers will focus on improving technique, speed, conditioning and increasing athleticism. Thus, developing sound technique and ultimately achieving their personal goals.

SWAT encourages every swimmer to participate in swimming competition and expect everyone to improve their technique, learn the mechanics of racing and feel the success of competition.

Our coaching staff will evaluate, recommend and assign each swimmer to a specific training group based on their ability, commitment, work ethic, maturity, and sportsmanship in the best interest of the swimmer. The following descriptions are general guidelines for each swim group.

Training Programs

Pre-Comp: This group focuses on techniques development while making transition from swim lesson.

Blue Fin, Yellow Fin, Red Fin: An intermediate level group of developmental swimmers that have a basic command of the four competitive strokes, but are in need of technique refinement and further aerobic conditioning.

High & Middle School Conditioning: High & Middle school age swimmers requiring stroke fine tuning and conditioning.

Silver Fin: A swimmer with 2-3 years of foundation and comfortable with all strokes, turns, dives, and race specific drills.

Black Fin: A highly competitive training group committed excellence and leadership National: Our most challenging level where 100% commitment is required.

SWAT coaches are dedicated individuals that build fitness, technique and character among the team. Our coaches are professionally trained as USA Swimming Coaches; certified in first aid and safety to include CPR; and members of the American Swimming Coaches Association. SWAT coaches supervises the entire competitive swim program and is dedicated in providing the best comprehensive training to encourage maximum participation. SWAT coaches provide an educational experience, enhance physical and mental conditioning, and develop a rich base of swimming talent.

WELCOME! SWIM WITH SWAT!

SWAT Training Programs

Coaching Staff

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Financial Commitment & Obligations

SWAT TRAINING PROGRAM:

All swimmers, whether competitive or non-competitive must pay the following:

ANNUAL REGISTRATION FEES: A non-refundable SWAT Registration is required per swimmer. This fee provides each swimmer with a team swim latex cap. Those families with 2 to 3 swimmers receive a registration discount (see registration form for more details). Families with 4 or more swimmers pay $15 each additional swimmer.

USA SWIMMING AND GULF SWIMMING REGISTRATION FEES: SWAT is affiliated with USA Swimming and Gulf Swimming or the Local Swim Club (LSC). These two governing bodies require an annual registration fee for all swimmers competing within this area. The fee for the 2015-2016 swim years is $74.00. This fee is a combined fee designated by USA Swimming and Gulf Swimming.

ADDITIONAL FEES: The Meet Entry Deposit Fee is $85.00 per person. This fee is used for those attending swim meets within the Gulf area. Each swimmer must deposit in escrow $85.00. Meet Entry fees apply to all swimmers participating with entry fees directly allocated to the hosting team. Please refer to Meet Participation for additional surcharges. There is a monthly Facility Fee of $5.00 to cover pool expenses.

Monthly Fee & Other Fees

All training group placement shall be the decision of the coaching staff. If a placement change becomes necessary, an increase in tuition fees will be applied at the time of the change.

Monthly Fee

Group 1st Swimmers 2nd Swimmers 3rd Swimmers 4th Swimmers 5th Swimmers Pre-Comp $100.00 $90.00 $80.00 $70.00 $70.00 Blue Fin $110.00 $100.00 $90.00 $80.00 $80.00 Yellow Fin $110.00 $100.00 $90.00 $80.00 $80.00 Red Fin, MSC $120.00 $110.00 $100.00 $90.00 $90.00

High School Cond (HSC) $120.00 $110.00 $100.00 $90.00 $90.00

Silver Fin $140.00 $130.00 $120.00 $110.00 $110.00

Black Fin $150.00 $140.00 $130.00 $120.00 $120.00

National $150.00 $140.00 $130.00 $120.00 $120.00

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Other Fees

Description Fee / Swimmer

Annual SWAT registration fee: $95.00; max: $270 per

family Non refundable USA Swimming / Gulf registration fee: All swimmers currently not registered

with USA swimming must pay this fee.

$74 annual Non refundable

Meet fees: SWAT will charge $1.00 per event per swimmer for swims at meets, In addition to the charge assessed by the team hosting the meet.

If Swimmers choose to attend a meet, there is a fee to compete depending on the host. This fee is separate of all other fees and is paid to the host of the event and NOT SWAT.

Estimated $5.00 - $10.00 per event plus $2.00 -

$10.00 per meet surcharge depending on the host.

Meet Entry Deposit Fee: This fee is used for those attending swim meets. Each swimmer must deposit an escrow $85.00. Meet entry fees apply to all

swimmers attending swim meets.

$85.00 per swimmer

Team T-Shirts: $10.00 for blended cotton

$25.00 for Dry-Fit

All registration and payments must be made by electronic fund transfer via debit, credit or bank draft. Electronic fund transfers will be scheduled on the 1st of each month. All transactions are subject to a $10.00 late fee and a $30.00 handling fee for Non-Sufficient Funds (NSF) or invalid cards/accounts due to expiration, etc. A written minimum thirty days (30) notice is required to cancel the membership. A swimmer must complete the Termination Form, at least 30 days before the termination date. The termination date must correspond to a month end. If you turn in your Termination Form less than 30 days before your specified month end Termination Date, you will be responsible for monthly swimming dues for the following month (as well as for the month the form is turned in). For example, if you submit your Termination Form on March 1st, you are obligated to pay dues for March and April, and your Termination Date is April 30th. The written notice must be on this SWAT Termination Form. The Termination Form is only accepted by dropping the form to SWAT representative(s) at the Don Cook Natatorium or Fort Bend Aquatic Practice Facility Lobby, by mail through the US Postal Service or emailing it to swat.membership@swimwithswat.org If you email the form, you will receive a confirmation email from SWAT membership. It is your responsibility to follow-up with SWAT membership if you do not receive a confirmation notice. Monthly fee will NOT be prorated, deducted or refunded regardless of the number of practices a swimmer attends in a month.

Note: Your swimmer will not be registered to compete until the meet entry deposit fee is paid.

This may be paid online through your SWAT account.

If any payments due SWAT are more than 10 days in arrears, your swimmer(s) will not be allowed to practice and or compete until payments are brought to a current status.

SWAT reserved the right to decline services to anyone. It is the sole discretion of the program director and executive management.

By completing and or signing this registration, I hereby agree to the above statements in the Southwestern Aquatics Team (SWAT).

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MEMBERSHIP APPLICATION

Thank you for joining SWAT! Please complete the information below.

Swimmer Information

Full Name:

Swimmer 1 M/F Y/N

Last First MI Birth Date Age Gender School Fort Bend

Resident

Full Name:

Swimmer 2 M/F Y/N

Last First MI Birth Date Age Gender School Fort Bend Resident

Full Name:

Swimmer 3 M/F Y/N

Last First MI Birth Date Age Gender School Fort Bend Resident

Full Name:

Swimmer 4 M/F Y/N

Last First MI Birth Date Age Gender School Fort Bend Resident

Parent Information

Full Name:

Parent 1

Full Name:

Parent 2

Last First MI Last First MI

USA Swim Information

Are you currently registered with a USA Swim Club?

YES NO

If yes, which team?

Last swim meet attended?

Date: USA Swim ID:

Disclaimer and Signature

As a member of a previous team, before joining Southwestern Aquatics Team, I certify that my answers are true and complete to the best of my knowledge and I was informed about Southwestern Aquatics Team via the internet, advertising or other publically available information and not individually recruited directly by any SWAT member.

Parent

Signature: Date:

Address:

Street Address

City State

Home: ( ) - Cell: ( ) - Work: ( ) -

Email:

Address:

Street Address

City State Zip

Home: ( ) - Cell: ( ) - Work: ( ) -

Email:

Circle One Circle One

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Swimmer’s Agreement to Hold Harmless

I, ______________________________________, (Print Name of Parent, Guardian, or Adult Swimmer)agree to and hereby release the Southwestern Aquatics Team(SWAT), the SWAT coaching staff and volunteers, the SWAT pool staff, as well as the Fort Bend Independent School District(FBISD), Gulf Swimming, Inc., and USA Swimming, their agents employees and affiliates from all liabilities and claims arising by reason of injuries that may occur to

___________________________________(Print Name of Swimmer) while participating in the programs of the SWAT. I agree to indemnify and hold harmless the SWAT and its staff; its members, agents, employees and affiliates from all claims, damages, losses including death, injuries, and expenses arising out of or resulting from participation in these activities. I further agree to release, acquit, and covenant not to sue the Southwestern Aquatics Team (SWAT) and its employees; and its members, agents and employees for all actions, causes of action claims or damages, damages in law or remedies in equity of whatever kind, including the negligence of the Southwestern Aquatics Team (SWAT) and its staff or my family, myself, or my heirs, against the Southwestern Aquatics Team (SWAT) arising out of participation in the swimming program or activities. In short, I cannot sue the Southwestern Aquatics Team (SWAT) and its staff, and its members, and if I do, I cannot collect any money.

Emergency Medical Treatment Authorization and Travel Permission

I, _____________________________________, (Print Name of Parent/Guardian) certify that to the best of my knowledge my child _____________________________________________ (Print Name of Swimmer),

___________________________, (Date of Birth) is in good health and has no health-related condition that could make it unsafe for him/her to participate in physical training and competitive swimming. I have attached a physician’s medical evaluation for any known conditions. I understand that the Southwestern Aquatics Team reserve the right to refuse any person it judges to be incapable of meeting the rigors and requirements of participating in the swimming program or activity.

Additionally, should my child require medical attention and I cannot be reached to make arrangements for emergency medical attention, I authorize the staff and/or coaches of the Southwestern Aquatics Team (SWAT) to take my child to the nearest emergency medical facility. I authorize the Southwestern Aquatics Team’s staff and coaches to obtain emergency medical attention and treatment for my child at a hospital or clinic of their choice. I give consent to the hospital, clinic, and/or physicians to render the necessary emergency treatment to my child. I further authorize staff and/or coaches of the Southwestern Aquatics Team (SWAT) to administer basic first aid to treat minor injuries.

Signature: Date:

Insurance Company: Policy Number:

Name of Insured: Group Number:

Emergency Contact Name: Phone Number: ( ) Work Phone: ( ) Relatives Phone: ( ) Cell Phone: ( ) Friend Phone: ( )

Photo Release (Permission Form for Minors)

I, _________________________________________________ (Parent/Sponsor/Guardian Name), being

Parent/Guardian of ___________________________________________ (Swimmer’s Name), hereby consent that photographs and/or videotape in which my child appears as a member of the Southwestern Aquatics Team may be used by the Southwestern Aquatics Team Swim Team, its assigns or successors, in whatever way they desire, including television, world wide web, and electronic media; furthermore, I hereby consent that such photographs and recordings from which they are made shall be their property; and they shall have the right to duplicate, reproduce, and make other uses of such photographs and tapes as they may desire free and clear of any claim whatsoever on my part.

=======================================================================================

I hereby agree to all above statements in the Southwestern Aquatics Team Hold Harmless Agreement, Medical Treatment/Travel Authorization, and Photo Release.

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Registration Form

Southwestern Aquatics Team (SWAT)

Full Name:

Swimmer 1 M/F

Full Name:

Swimmer 2 M/F

Full Name:

Swimmer 3 M/F

Full Name:

Swimmer 4 M/F

Groups: Pre-Comp, Blue Fin, Yellow Fin, Red Fin, Silver Fin, Black Fin, National, HS / MS Cond.

Swimmer 1 Swimmer 2 Swimmer 3 Swimmer 4 TRAINING PROGRAM

List training group/ swimmer

COST

Monthly Tuition

($100, $110, $120, $140 or $150)

$100, $110,

$120, $140 or

$150 Monthly Facility Fee: ($5.00) $5.00 High / Middle School Conditioning ($120)

SWAT Annual Registration

Non-refundable Fee ($95.00). $95.00 85.00 (180.00)

75.00 (255.00)

15.00 (270.00) USA & Gulf Annual Registration Fee

($74.00)

Meet Entry Deposit Fee($85.00) Surcharge Fee ($1.00 per event)

T-shirt ($10.00 ea.) x

$10.00

Total Cost

MAKE CHECK PAYABLE TO: SOUTHWESTERN AQUATICS TEAM OR SWAT

T-Shirts (Please mark size and quantity): ______Youth Small ______Youth Medium ______Youth Large

______ Youth X Large ______ Adult Small ______ Adult Medium ______ Adult Large ______ Adult XLarge ______Adult XXLarge Additional T-shirt order: $10 x ________________________

All monthly dues received after the 1st of each month are subject to a $10.00 late fee. There is also a $30.00 handling fee on all returned checks &

electronic insufficient funds, invalid card numbers & etc.

Parent Signature Date

Circle One

Circle One

Circle One

Circle One

Last Name First Name M.I. Grade Training Program

Last Name First Name M.I. Grade Training Program

Last Name First Name M.I. Grade Training Program

Last Name First Name M.I. Grade Training Program

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Credit / Debit card payment, Electronic Funds Transfer Authorization Form

As a duly authorized credit / debit card signer on the credit / debit card financial institution account or check signer on the financial institution account identified below, I authorize “Southwestern Aquatics Team (SWAT)” to perform scheduled or periodic electronic funds transfer debits and/or credits from my account identified below for payments due or when applicable, apply electronic funds transfer credits to the same. This applies to credit / debit card or check by phone payments as well as any other electronic payment. I understand the dollar amount can vary depending on services performed.

Furthermore, if any such electronic debit(s) should be returned by my financial institutions as Non-Sufficient Funds (NSF), I authorize, “Southwestern Aquatics Team (SWAT)”, to collect a returned item fee of $25.00 per item by electronic debit from my account identified below.

For accounting purposes, all electronic debits will be reflected in the monthly credit / debit card statement or bank statement that corresponds with the financial institution account identified below.

I understand and authorize all of the above as evidenced by my signature below.

AUTHORIZING SIGNATURE:_____________________________________ DATE:___________________

Credit / Debit Card type: Authorized Card #: Exp. Date:__________________

Security Code on back of card:______________________

OR Financial Institution account “identifying information”:

Enter financial institution account information into the fields provided below or attach a blank VOID check.

Financial Institution: Branch:

City: State: Zip

9 Digit Transit/ABA # Account #

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