Ripon Aquatics Membership Registration Form

Ripon Aquatics Club Membership Registration

Please complete the form below to sign up
Member Name*

First NameLast Name
Birth Date (ages 5+)*

YearMonthDay
Parent or Legal Guardian

First NameLast Name
Phone Number:*

Area CodePhone Number
Emergency Contact

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
E-mail (for club newsletters and invoicing)*
Optional E-mail
example@example.com
Address:*

Street Address

Street Address Line 2

City

Zip Code
Are you interested in?*

SwimmingWater PoloBoth
Do you have any swimming or water polo experience?

YesNo
Do you have any medical history or conditions that could affect your ability to participate in contact sports? *

NoYes (Please enter details)
Medical Conditions
I am a member of

United States Swimming Association
USA Swimming Member Number
I am a member of:

United States Water Polo Association
USA Water Polo Member Number
Where did you hear about us?

A Friend or colleagueOnline Search (Google, Bing, Yahoo)Swimming WebsiteLocal Activities ListingNews ArticleOther
Payment Policy
I understand that Ripon Aquatics Club does not require members to sign a contract for an extended period of time, and members may cancel at any time by notifying a manager. There is a $25 registartion fee for each member upon starting. If you decide to discontinue your mebership and come back at a later date you will be requied to pay the $25 registration fee again.

I understand that Ripon Aquatics Club is a coached owned entity and relies on the prompt club dues payments of members to stay open. I agree to pay my club dues as soon as possible, cash or check payable to Ripon Aquatics. If I am unable to make a payment, I will notify a club manager and make an arrangement. Club dues are not tax deductible.

I understand the coaching payment ae due by the 5th of each month.

I understand there is a one time $25 registration fee due upon first practice.

I understand that i will be resposible for paying the yearly USA Swimming Mebership fee upon request.
I have read and understand the payment policy
Membership Rules
Membership Rules
1. No food, drink or chewing of gum are allowed on the deck with exception of water.
2. Report all injuries to the instructor immediately. When arriving at practice with an injury, the instructor must be notified prior to the start of practice.
3. Never come to practice under the influence of drugs or alcohol.
4. Members are to keep their equipment clean and in good repair.
5. Finger and toenails are to be kept clean and trimmed to a reasonable length to prevent injuries to training partners.
6. No jewelry may be worn during class unless specifically approved by the instructor.
7. Spills are to be cleaned immediately. Trash should be placed in the proper container.
8. Bullying is not tolerated in or out of the facility.
9. No running, playing,or roughhousing on the deck at anytime.
I have read, understood, and accepted the rules for membership.
Parent Support Commitments:
1. Parents must be on time with picking up or droping of thier children(s) for practice.
2. Parents must assist with timing responsibities at swim meets.
3. Participation in the Annual Ripon aquatics Crab Feed. This event occurs in March of each year and is our biggest team fundraiser. Families are required to sell tickets for the crab feed, donate towards "themed" baskets, which will be part of the Crab Feed Raffle, and assist on the evening of the event. (This requirment is non-applicable for Extended Swimmers)
4. Volunteers are welcome. If you are interested in volunteering and have skills in a particular area, please let us know.
I have read, understood, and accepted the rules for membership.
Privacy Policy
I understand that occasionally, photos and videos from club competitions and practices will be used in promotional material for the club. I agree to allow my image or my child's image to be used for this purpose and that I will not be compensated. I also understand that once a promotional item has been produced, it is not possible to remove my image or my child's image from the production.
I understand that the club will never share my contact information for commercial purposes. I may, however, be contacted by the club managers about club announcements and information relevant to club membership.
Disclaimer and Waiver of Liability
1. Recognize and understand that swimming and/or water polo training is a physical contact activity and that my participation might result in serious injury, including permanent disability or death, and severe social and economic loss.
2. Recognize and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others.
3. Recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
4. Agree to inspect the facilities and equipment prior to participation. I will immediately inform an instructor if I believe that anything is unsafe or beyond my capability and refuse to participate.
5. I certify that I am in good physical condition, and have no disease, injury or other condition that would impair my performance or physical and mental well-being during training practice and/or competition. If I have any injuries or illnesses that could affect my ability to participate, I will notify the club managers and coaches, and discuss the appropriateness of martial arts training with my or my child's doctor.
6. Grant permission in case of injury to have a doctor, nurse, athletic training or other emergency medical personnel provide me or my child with medical assistance or treatment for such injury. The cost of any treatment or hospitalization arising from injury during training or play shall not under any circumstance be paid by Ripon Aquatics Club or coaches.
7. In consideration of the privilege of membership on Ripon Aquatics, I/we, the parents/guardians of the swimmers named above hereby hold the team, and employees free and harmless from any liability for loss, injury or damages they, or our swimmer(s) may incur as a result of participation in team events, activities, including travel to and from such activities, and we assume the team's responsibility for such liability. I/we will pay for all collection costs incurred by ripon Aquatics including court costs, if necessary.
I have read, understood, and accept the disclaimer and liability waiver and sign it of my own free will
Signature of Member or Legal Guardian*

Clear
Should be Empty:

Ripon Aquatics Club Membership Registration

Payment Policy

Membership Rules

Parent Support Commitments:

Privacy Policy

Disclaimer and Waiver of Liability