Professional Documents
Culture Documents
2017 Boys Registration
2017 Boys Registration
2016/2017
SWIMMING PROGRAM FOR BOYS
NAME OF SWIMMER
DIVISION
PRESENT AGE
DATE of BIRTH
PARENTS NAME
SCHOOL
PARISH
ADDRESS
GRADE
MEDICAL INFO
(Asthma,allergies,etc.)
HOME PHONE
E-MAIL ADDRESS
PRINT CLEARLY
I hereby give my child________________________________________permission to participate in the TRI-M CYO swim program. I authorize a coach, trained lifeguard
or adult representative of the team to provide emergency treatment of an injury or illness to my child. This authorization is granted only if I cannot be
reached and a reasonable effort has been made to do so.
Parent or Guardian's Signature______________________________________________
I understand that this team/program operates solely on the swim fees paid by the participants. All personnel are volunteers except for the lifeguards.
I hereby agree to volunteer my time for locker room duty as the program needs me.
Parent or Guardian's Signature______________________________________________
If you have any questions, please call Mary Leong 718-793-4082
TEAM______
CLUB________
FOR OFFICE USE ONLY
PAID__________________
CHECK# OR CASH____________
HS_______