JCCNS Sea Serpents Registration Form 2021-22

JCCNS Registration Form 2024-25
Swimmer Information:
Child's Name (Include Middle)*
Date of Birth *
Age*
Gender*
Group Placement & Monthly Fee (Includes All Meet Fees):*

MINI Green $140MINI White $180Age Group Green $220Age Group White $260Age Group Black $280Senior Green $300Senior White $340Senior Black $360Unsure of Group Placement
Additonal $50 Team / Coaches / Officials, Reg. Fee Charged in December or at time of registration if joining after December.

$100 USA Registration Fee Paid through USA swimming when registering your swimmer for the 2025 competition year. USA Registration is required for all swimmers wishing to compete in any swim meet other than "FUN" Meets.

There is a new system for registering with USA swimming, like last year each parent will be required to login to their USA swimming account and register their swimmer(s) prior to December 1st, 2024 for the 2025 year of competitions. More info TBA.
Parent / Guardian Information:
Parent / Guardian Names*
Home Address *
City / State / Zip *
Reachable Phone Number(s)*
Email Address *
Emergency Contact & Phone Number*
Payment*

Automatic Withdrawal Monthly (11 months: Sept-July) (Swimmer's not participating over the summer or switching to Summer Jellies will have the opportunity to stop withdrawals with June.)5% Discount Pay Year In Full10% Discount Parent is an Official5% Multiple Swimmers Sibling Discount (Apply to Each)
JCCNS Membership*

Currently a MemberIn ProgressNon Member
All Sea Serpent Swimmers must be JCCNS Members.
My Swimmer and I have read and will abide by the Team Uniform and Tech Suit Policy.*

Yes
Team Uniform & Tech Suit Policy
My swimmer and I have read and will abide by the Team Code of Conduct and Travel Policy.*

Yes
Code of Conduct & Travel Policy
I have read and will abide by the 2021 USA Swimming MAAPP Safe Sport Policy, link bellow.*

Yes
Safe Sport Minor Athlete Abuse Policy

Sea Serpents Safe Sport Info
18 & Older Athletes and Swimmers turning 18 before Aug. 31 2025. I have completed the Athlete Protection Training, link bellow. (Swimmer must create their own USA Registration Account separate from parents first)*

YesN/A (Swimmer is under 18 all year)Will complete at least two weeks prior to turning 18.
Athlete Protection Training
I understand and agree that the FINA Anti-Doping Rules and U.S. Anti-Doping Agency Protocol for Olympic and Paralympic Movement Testing (USADA Protocol) and all other policies and rules adopted by FINA, USADA, and the USOPC apply to my swimmer and that it is my swimmers and my responsibility to ensure compliance with these rules. I agree to have my swimmer submit to drug testing at any time and understand that the use of methods or substances prohibited by the applicable anti-doping rules would make my swimmer subject to penalties including, but not limited to, disqualification and suspension. If it is determined that they may have committed a doping violation, I agree to submit my swimmer to the results management authority and processes of USADA, including arbitration under the USADA Protocol, or to the results management authority of FINA and/or USA Swimming, if applicable or referred by USADA. (Typical first level in which drug testing occurs, USA Futures)*

I have read the statement above: Understand & Agree
USADA Website
For New Swimmers. I have completed & turned in the First Aid & Medical Care Consent Form.*

N/A Returning Swimmer, i.e. form turned in a past year.YesWill turn in before first practice
First Aid & Medical Care Consent Form
For New Swimmers. I have turned in team bank draft form or have a card on file.*

N/A Returning SwimmerYes Form Turned InCard on FileWill turn in before first practice
Bank Draft Form
Parent / Guardian Signature *

Clear
Date*
Photography and/or video may be taken of your swimmer for educational and promotional purposes throughout the season. If you would NOT like your swimmer to be photographed and/or videotaped please let Head Coach Ashley know via email avieira@jccns.com.

Photography is prohibited in locker rooms or bathrooms or any location in which an individual may be getting dressed.

Photography is also prohibited behind the blocks at swim meets.

JCCNS Registration Form 2024-25