REGINA PIRANHAS SPEED SWIMMING CLUB

2013 REGISTRATION

  • 4 nights/week – 5-7 hours/week pool time. (May–June-July)
  • This program is geared to swimmers between the ages of 7 and 18.
  • Mini -Piranhas – 5-7yrs. 2 nights a week/30 min class (only offered if there are at least five registrations)

Name: / Male/Female
Address:
Postal Code:
Phone Number: / Cell Number:
E-mail Address:
Birthdate:
Parents/Guardians:
Parent(s) Work Numbers: / Cell Numbers:
First Contact In Case of Emergency: / Phone Number:
Hospitalization #:
Doctor’s Name/Phone:

Regina Piranhas Summer Swim Club Page 1 of 3

My child has medical conditions/allergies, which include: (asthma, diabetes, epilepsy, etc.):

My child is taking the following medications:

Injuries from the past (concussions, breaks, blackouts, etc.). Please be specific.

Previous speed swimming experience:

If a new swimmer: Where did you hear about the Piranhas Swim Club?

I give permission for ______to participate in practices, drills and swim meets with the Regina Piranhas Swim Club Inc and do hereby state that the above mentioned person is capable of meeting the physical and mental demands of speed swimming. I do not hold the Regina Piranhas Swim Club Inc., responsible for any injury that may be incurred by my child while participating in speed swimming.

The Regina Piranhas Summer Swim Club (RPSSC) has a policy of zero tolerance for bullying and harassment. We follow the policies of Swim Saskatchewan in regards to bullying and harassment. Athletes or parents not following these policies will be asked to leave the club. In such circumstances all fees paid will be forfeited.

I understand that by joining the Piranhas Summer Swim Club our family will provide two volunteers for all of the sessions of the RPSSC swim meet on June 22, 2013.

I understand that RPSSC is a competitive swim club and I will attend as many swim meets as possible.

All fees are non refundable with the exception that a swimmer is unable to continue due to injury or other medical condition and that written notification from a medical practitioner may be requested. The above mentioned notification will be submitted to the RPSSC Executive for pending approval of reimbursement. Reimbursements will be considered on a pro rated basis.

For safety and liability reasons we respectfully request that parents and family members do not accompany your swimmer on the pool side deck during practices without expressed invitation by a coach. As well, we require that all swimmers notify a coach whenever a swimmer leaves the pool prior to the end of practice for any reason.

RPSSC has a website where we will be posting pictures of our club members ( If you would not like to have your child’s picture posted to the website, please advise club president, Debbie Johnson.

I have read the Fees, Fundraising Requirements, and Volunteer Expectations (on page 3 which I can take home).

______

Signature of SwimmerSignature of Parent/GuardianDate

*This completed registration form and cheque(s) can be sent to:

Marj Walsh – RPSSC Registrar

3271 Margaret Rd

Regina, Saskatchewan S4V 1B2

Fees:

1 child/family$400(plus $100 fundraising fee per family)

Each additional child$350

Mini Piranhas $200 (class only offered if there are at least five registrants. Swimmers must be comfortable in the water.)

*You can divide your fees in half and provide 2 postdated cheques payable May 1, 2013

June 1, 2013. Postdated cheques must accompany your registration. Cheques payable to RPSSC.

Fundraising Requirements:

  • Each family is required to provide a prize basket(s) valued at $40.00 for the prize table at our swim meet. You can choose to bring one basket worth $40 or two baskets valued at $20 each.
  • Fundraising fee: $100/family. Separate cheque postdated to June 30th, 2013. May be reimbursed based on fundraiser participation.

Volunteer Expectations:

  • Regina will be hosting oneregular swim meet this year. To ensure the success of the meet, each family MUSTprovide a minimum of 2 volunteers for the meet on June 22, 2013.
  • We encourage our parents to take officials training and advance through the officiating levels so you can assist in various capacities for the swim meets. Please talk to a board member for more information.

Please take this 3rd page home for future reference.

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