2014 registration

2014-15 Family status
AQUASTAR SWIM TEAM 2015 FAMILY REGISTRATION
Parents'/guardians' full names
Address
City, ZIP
Home phone
Mom cell phone
Dad cell phone
E-mail to be used for LOGIN to website and receive invoices and team news
The email address I just entered is:
Additional E-mail #1 (will receive team news)
Additional E-mail #2 (will receive team news)
Swimmer #1 information:
Full name (First, MI, Last)
Middle initial is used for establishing the athlete's correct unique USA Swimming ID. Please supply, if athlete has a middle initial.

Write NONE if athlete does not have a middle initial.
Sex
Birth Date

MonthDayYear
Age when registering
Swimmer #2 information:
Full name (First, MI, Last)
Middle initial is used for establishing the athlete's correct unique USA Swimming ID. Please supply, if athlete has a middle initial.

Write NONE if athlete does not have a middle initial.
Sex
Birth Date

MonthDayYear
Age when registering
Swimmer #3 information:
Full name (First, MI, Last)
Middle initial is used for establishing the athlete's correct unique USA Swimming ID. Please supply, if athlete has a middle initial.

Write NONE if athlete does not have a middle initial.
Sex
Birth Date

MonthDayYear
Age when registering
Form Submission & Release Acknowledgement
By submitting and signing this form below, I acknowledge that I have read and agree to abide by the MEDICAL AUTHORIZATION, RELEASE, FEE PAYMENT/TEAM POLICIES, AUTOMATIC ELECTRONIC PAYMENT POLICY, and BY-LAWS of the Bay Area Aquanauts, Inc., d/b/a AQUASTAR Swim Team. The links to these documents may be found by clicking HERE.
Parent/guardian signature
Date submitted

MonthDayYearHourMinutes
Should be Empty:

AQUASTAR SWIM TEAM 2015 FAMILY REGISTRATION

Swimmer #1 information:

Swimmer #2 information:

Swimmer #3 information:

Form Submission & Release Acknowledgement