Panama City Swim Team - Tsunamis - Swimmer Registration Form

FAMILY NAME:  ______________________________________________________

Parent/Guardian First Names: ________________________ & _____________________________

Mailing Address: __________________________________________________________________

City: _______________________________  State:____________  Zip Code __________________

Billing Address:  (if different from mailing address) _______________________________________

Email Address ___________________________________________________________________

Home phone:  _____________________________  Work phone: ___________________________


SWIMMER INFORMATION:  

1) First Name:  ________________________ MI  ______  Last Name: _______________________

Birthdate:     ________________________   Age: ______   Sex:  M ____  F _____

Previous swimming experience (swim team, learn to swim etc.) _____________________________

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2) First Name:  ________________________ MI  ______  Last Name: _______________________

Birthdate:     ________________________   Age: ______   Sex:  M ____  F _____

Previous swimming experience (swim team, learn to swim etc.) _____________________________

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In order to help us understand your expectations and objectives with the swim team, please
provide the following information:

I am joining the swim team for the following reason:
      ___  social activity    ___ exercise only   ___  to improve as a swimmer and attend some meets  
      ___  to attend meets regularly and be very competitive  
      ___  other reasons - please specify: ________________________________________________

I plan to attend practice:
      ___ 1-2 times/week    ___  3-4 times/week    ___ 5 times/week

3. My hobbies are: _________________________________________________________________

4. I would like to be called by the following name: ________________________________________

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