2023-2024 Recreation Registration

Athlete's Name

Date of Birth (yyyy-mm-dd)

Address

Postal Code

Guardian Name

Phone Number

Email

Second Guardian (optional)

Second Phone Number (optional)

Second Email (optional)

MCP Number

Allergies/Medical Conditions/Mental Health Conditions

Athlete's Swimming Experience (Swim Lessons, Rec or Competitive Synchro, etc.)

Program

• Recreational (Saturday evenings)
• Recreational (Sunday evenings)
• Pre-competitive

I hereby grant permission, in the event of illness or injury, for an official chaperone, coach, or manager to provide my child with medical assistance and/or treatment

• I agree
• I do not agree

CBS Silhouettes may promote synchronized swimming by posting photos/videos of its athletes on social media platforms or promotional materials..

• I agree
• I do not agree

I have read and agreed to Assumption of Risk form (for those under 19), Declaration of Compliance (for everyone), and Release of Liability, Waiver of Claims and Indemnity Agreement (for those 19 years and older

• Yes
• No