Registration Form

Registration Form

Welcome to Yarra Plenty Waves
Athlete Details
Athlete Full Name

First NameLast Name
Birth Date

DayMonthYear
Gender
Squad
Masters
School Attending
Multi Class (Has Disability)
Coach(es) who assessed athlete?
Athlete Mobile
Optional for under 18 swimmers (parent mobile entered in the next section)Format: 0000 000 000.
Athlete Email
Optional for under 18 swimmers (parent emails entered in the next section)
Account payments to be sent to
Masters Fee Option
Fee Option
Contact Details

Responsible for account payments. Term fees invoiced per term. Sent from Yarra Swim School.
Full Name

First NameLast Name
Postal Address

Street Address

XX

SuburbPostcode

Post Code
Mobile
Please enter a valid phone numberFormat: 0000 000 000.
Email
Invoices will be sent to this address
Municipality

Other
Swimming History
How Did You Hear About Us?

Other
Previous Swim Club / Swim School Name
Date Started {previousSchool}

DayMonthYear
Date
Date Finished {previousSchool}

DayMonthYear
Date
Additional Notes
Privacy Statement:

The personal information contained in this document is collected to provide contact information for organisations or individuals, wishing to enrol into squad training. This information may be disclosed to other areas of Yarra Plenty Swimming Club Inc. or third parties should contact the necessary regarding an issue with the booking, and in accordance with the Information Privacy Act.
Admin Use
Should be Empty:

Contact Details