Participant's Name *

First Name

Last Name

Team Registering For

Swim Team

Dive Team

Both Swim & Dive Team

Participant Status *

Returning Participant

New Participant

Participant's Birthdate *

MM

DD

YYYY

Gender *

Female

Male

Swim Team Age Group (if registering for Swim Team)

Pre-Competition

5/6

7/8

9/10

11/12

13/14

15/17

Dive Team Age Group (if registering for Dive Team)

8 & Under

9/10

11/12

13/14

15/17

Membership Type *

Please note that participants must have a FULL SEASON, FAMILY, MEMBERSHIP in order to be eligible to participate on the PVSC Swim and Dive Teams. Weekend/Holiday Memberships as well as individual memberships, are not valid for participation.

Bonded Family

Non-Bonded Family

Primary Contact Number *

(###)

###

####

Secondary Contact Number

(###)

###

####

Emergency Contact (if parent(s) cannot be reached) *

First Name

Last Name

Emergency Contact Number *

(###)

###

####

Volunteer Agreement *

I understand that I am obligated to volunteer a minimum of three times and agree to do so

I opt out of volunteering and will submit an additional $50 check made out to "Pascack Valley Swim and Dive Team".

Photo Release

I authorize the PVSC to use photographs of my child that were taken at swim meets or other swim team functions. I recognize that these photos may be posted on the team Facebook and other social media outlets, used by news media, or used by the PVSC for promotional purposes. *Participants' names WILL NOT appear on social media

I GIVE permission for photographs of my child to be used

I DO NOT give permission for photographs of my child to be used

Date *

MM

DD

YYYY