Swimming Club Registration Form

Corrigin Amateur Swimming Club Registration
Complete the form below to sign up for to become a swimming member.
Registration Type*
Membership Type*
Swimmer Details*
First NameLast Name
Birth Date:*
MonthDayYear
Address*
Street Address
Street Address Line 2
CityState
Postal code
Emergency Contact Information*
First NameLast Name
Relationship*
Phone*
Mobile*
E-mail*
In Case of an emergency, do you authorise the Corrigin Amateur Swimming Club Inc to arrange any necessary Medical Treatments for your child where prior notification has not been possible.*
YESNo
Signature*
Clear
Medical Conditions. Does your child suffer from any medical conditions (allergies, asthma, etc..?)*
YESNO
If YES, please provide details.
Membership Code of Conduct and Terms & Conditions
Please read the attached file
Privacy Policy
Personal information collected by the Corrigin Amateur Swimming Club is for the primary purpose of membership requirements and coach information. It will not be released for any form of commercial gain and will be maintained in a secure environment as per the requirements of the Privacy Act.

By registering with the Corrigin Amateur Swimming Club for the 20/21 season I/We hereby give permission for the Club Coach and/or a member of the Committee to photograph and use images for use in team photographs, press releases and swimming club use only.

I give permission for images of my child to appear on the Corrigin Amateur Swimming Club’s private Facebook group, this group is only accessible by current members. Images will be deleted at the beginning of each season.
I am the parent/guardian of the swimmer and have read, understood, and accepted the PRIVACY POLICY for membership.
Swimming WA Declaration
I agree to abide by the rules, regulations and policies of Swimming WA, Swimming Australia, the relevant Regional Swimming Association and the relevant club, including Swimming Australia’s Anti‐Doping, Member Protection, Behaviour Guidelines and Privacy Policies (these are available at www.swimming.org.au).

I authorise Swimming WA to use and disclose, to related and relevant bodies any of my personal information that may be necessary to implement the rules, regulations and policies in 1 above. I agree to have my name, results and any photograph taken during events conducted by Swimming WA, unless I or any guardian indicate otherwise, published in official programs,
newsletters and websites and other media.
I am the parent/guardian of the swimmer and have read, understood, and accepted the Swimming WA Declaration for membership.
*
prevnext( X )
Seasonal SwimmerSeasonal Swimmer (9+) SWA $99.00, CASC $21.00
$120.00AUDQuantity

Junior Dolphin (5-8)Junior Dolphin SWA $30.00, CASC $20.00
$50.00AUDQuantity

Family FeeFamily Fee, payable once per family CASC $30.00
$30.00AUDQuantity

Parent/GuardianParent/Guardian, payable per parent/guardian SWA $5.00
$5.00AUDQuantity

Total
$0.00AUD
Once you submit your application, we will contact you shortly to complete your membership application. Thank you!
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Corrigin Amateur Swimming Club Registration

Membership Code of Conduct and Terms & Conditions

Privacy Policy

Swimming WA Declaration