Please fill out separate forms for each child and return them to the pool with the appropriate fee.
Fees are $70.00 for the first child, $30.00 for the second, and $15 for the third.
A family fee of $115 will be charged if there are more than three children.
Pre-team fees are $100 per child regardless of number of children.
Please write a check payable to the Diamond Farm Swim Team.

SWIMMER’S NAME ______________________________________________________________

ADDRESS ______________________________________________________________________

PHONE ____________ (HOME) _________________ (WORK)

E-MAIL ADDRESS ________________________________________

BIRTHDATE __/__ /__ PARENT’S NAMES ____________________________________________

ANY HEALTH CONDITIONS WHICH MAY REQUIRE TREATMENT ________________________

________________________________________________________________________________

________________________________________________________________________________

EMERGENCY CONTACT:

NAME: __________________________________________ PHONE: _______________________

________________________________________________________________________________

___________________   has my permission to swim on the Diamond Farm SwimTeam. By signing this
(swimmer’s name)

form, I also agree to assist the team in some manner such as timing, ribbon writing, baking or selling at
home meets. I understand that I may be phoned about this manner.

I understand that Diamond Farm Home Corp., Georgetown Aquatic Corp., or anyone involved with the swim team will not be liable for accidental injury occurring to my child while participating in swim team activities.

SIGNED ___________________________________________ DATE _______________________
                               (Parent or Guardian)