Westhaven Waves Swim Team

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WESTHAVEN WAVES 2019 ONLINE REGISTRATION FORM

* Is this your first year with Westhaven Waves Swim Team?:

Elks Lodge Member#:

SWIMMER INFORMATION

SWIMMER 1

* First Name:

* Last Name:

* Gender:

* Age as of June 1, 2019:

SWIMMER 2

First Name:

Last Name:

Gender:

Age as of June 1, 2019:

SWIMMER 3

First Name:

Last Name:

Gender:

Age as of June 1, 2019:

SWIMMER 4

First Name:

Last Name:

Gender:

Age as of June 1, 2019:

CONTACT INFORMATION PARENT or GUARDIAN

* First Name:

* Last Name:

* Email:

* Street:

* City:

* State:

* Zip Code:

* Cell Phone:

Is Texting Ok?:

Work Phone:

Home Phone:

First Name:

Last Name:

Email:

Home Phone:

Work Phone:

Cell Phone:

EMERGENCY CONTACT INFORMATION

Emergency Contact Name:

Phone:

Relationship to Player:

* Each family must provide at least 1 Volunteer to work at each Swim Meet your child is participating. Your initials are required for acknowledgement.:

Registration fees are due by May 29th.

* indicates required fields

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WESTHAVEN WAVES 2019 ONLINE REGISTRATION FORM