Competitive Registration Form 2021-22

Competitive 2021-22 Season Registration Form
Swimmer's Name *

First Name Last Name
Swimmer's Date of Birth *

Month Day Year
Date of Birth
Swimmer's Gender *

Male Female
Swimmer's email (if they have one)
Swimmer's Mobile (if they have one)
Competitive Program Selection *

Novice (Swansea) Novice (Weston) Age Group 2 Age Group 1 Junior Senior
Swimmer's OHIP Number *
Swimmer's Health Information
(include any known medical conditions, allergies, medications, and COVID-19 vccination status)
Swimmer's Home Address *

Street Address

Street Address Line 2

City Province

Postal Code
Parent/Guardian (#1) Information *
Parent/Guardian (#2) Information
Membership Agreement & Liability Release *
Photographic Release *
Email Release *
Registration and Program Fees *

I hereby confirm that I have reviewed and agree with the York Swim Club 2021-22 Program Fees as shown on the York Swim Club website - www.yorkswimclub.ca and as shown below
York Swim Club - 2021-22 Competitive Fees
Name of Person completing Registration *

First Name Last Name
Email of person completing Registration *
example@example.com
Date Signed *

Month Day Year
Date
Signature of person completing Registration (must be over 18) *

Clear
Should be Empty:

Competitive 2021-22 Season Registration Form