Whitesburg Recreation Association Swim Team Registration Form
Swimmer(s) Information:
Name				Birth:		Age:		Sex:		T-Shirt Size
	Last	First	Middle		MM/DD/YYYY				M/F
Name				Birth:		Age:		Sex:		T-Shirt Size
	Last	First	Middle		MM/DD/YYYY				M/F
Name				Birth:		Age:		Sex:		T-Shirt Size
	Last	First	Middle		MM/DD/YYYY				M/F
Name				Birth:		Age:		Sex:		T-Shirt Size
	Last	First	Middle		MM/DD/YYYY				M/F
Name				Birth:		Age:		Sex:		T-Shirt Size
	Last	First	Middle		MM/DD/YYYY				M/F
Parent Information:
Parents:
Address
	Street			City		State		Zip
Home Phone:				Work Phone:
Cell Phone/Pager:				E-mail address:
Medical Release:
Please list any medical problem or allergies that your child(ren) may have:
How do we need to treat the problem:
I give permission for my child(ren) to be treated in an emergency in the event I cannot be reached.
							Date
Emergency Numbers:
Name:					Phone:
Name:					Phone:
Doctor's name:					Phone:
Fees:  Make checks payable to Whitesburg Recreation Association
1 Swimmer - $81 / 2 Swimmers - $122 / 3 or more Swimmers $142
# swimmers:					Total due swimmers::
# Trophies (optional) - $7.00 each					Total due Trophies:
For official use:
Amount Paid			Check #			Date:
Whitesburg Recreation Association Swim Team Volunteer Form
Volunteer's Name(s):
		Each family that has a swimmer on the Whitesburg Swim Team is required to work at least one swim meet. We rely heavily on the support of our team parents.  Your commitment during the swim season is greatly appreciated.  Please check which jobs below you would like to volunteer to work during the summer.  Thank you!
		Volunteer Position			Home Meet		Away Meet
		Referee *			1 needed		0 needed
		Starter *			1 needed		0 needed
		Place Judge - Caller			1 needed		1 needed
		Place Judge - Scribe			1 needed		1 needed
		Stroke & Turn Judge *			1 needed		1 needed
		Runner			1-2 needed		0 needed
		Timers/Head Timer			7 needed		2 needed
		Scoring Table / Computer			3 needed		2 needed
		Ribbons			2 needed		2 needed
		Bullpen			1-2 needed		1-2 needed
		Concessions Coordinator			1 needed		0 needed
		Concessions Worker			4-6 needed		0 needed
		Volunteer Coordinator			1 needed		1 needed
		Fundraising Coordinator			1 needed		1 needed
		* Training required.  Please see the swim representative for information on exact requirements and available training sessions.  These positions are essential and we are in need of as many new officials as possible.  Please consider taking the training and test.
	Complete both sides of this form and return to:
		Eileen Bogardus		7307 Atwood Dr. Hsv, AL 35802