Zena Sun Devils Registration Form

Swimmers Information

1st Swimmers Name*

First NameLast NameNickname

1st Swimmers Gender*

MaleFemale

1st Swimmers Birth Date*

MonthDayYear

2nd Swimmers Name

First NameLast NameNickname

2nd Swimmers Gender

MaleFemale

2nd Swimmers Birth Date

MonthDayYear

3rd Swimmers Name

First NameLast NameNickname

3rd Swimmers Gender

MaleFemale

3rd Swimmers Birth Date

MonthDayYear

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Parent/Guardian #1*

First NameLast Name

Cell Number*

Work Number

E-mail*

example@example.com

Parent/Guardian # 2

First NameLast Name

Cell Number

Please enter a valid phone number.

Work Number

Please enter a valid phone number.

Email

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Alt. Phone Number

Swimmers Health History

Child's Physician*

First NameLast Name

Physician Phone #*

Please enter a valid phone number.

Date of Last Physical*

Date

Medical Waiver

I, the parent/guardian of the above named child(ren), hereby give approval for the participation in any and all Zena Recreation Swim Team activities. I also state that the above named have been examined by a physician and found to be in good health and fit for a season of competitive swimming. In case of emergency, should the family physician not be able to be reached, I hereby authorize another available, licensed physician to treat my child(ren).

I understand that prior to my child(ren) being able to practice or compete with the swim team that this medical release from must be complete and the team fee paid. I also give permission for photographs and/or videos of my child to be used on the Zena Rec website and on team videos unless I opt out in writing and notify the Park at the above noted address.

Signature*

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Zena Sundevils Code of Conduct

As a member of the Zena Sundevils swim team, I realize my child is part of an organization that believes teamwork, integrity, respect, and good sportsmanship are more important than winning. I understand, my child, as a swimmer, must be gracious in defeat, modest in victory, and maintain self-control. By signing this Code of Conduct, I agree both my child and I will follow the rules for behavior and sportsmanship while we are members of the Zena Sundevils. In addition, To read and understand the DUSO Code of Conduct that all swimmers and parents are expected to follow, I understand I can go to www.duso.org.

1. We will encourage good sportsmanship.

2. We will attend every practice that we can.

3. We understand that the coach has final say in the events that swimmers swim during meets.

4. We will do our very best to listen and learn from the coaches.

5. We will treat the coaches, other swimmers, officials, and spectators with respect regardless of race, gender, creed, or abilities and expect to be treated accordingly.

6. We will behave in a way which ensures the health, safety and well-being of any coach, swimmer, official or spectator during any swim functions.

7. We will not use profanity or abusive language and will not engage in verbal or physical threats.

Signature*

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Swim Team: 1st Swimmer

$135.00 Member/Non-MemberAge on 7/01/23Size

Swim Team: 2nd Swimmer

$125.00 Member/Non-MemberAge on 7/01/23Size

Swim Team: 3rd Swimmer

$115.00 Member/Non-MemberAge on 7/01/23Size

Swim Team: Extra Team Shirt Great for Parent or as a collectable Team Shirt w/logo

$22.00 SizeQuantity

Swim Team: Yeti Raffle Tickets Ticket can be sold to friend or kept for yourself. Ticket will be given out the first full week of practice. Winners will be drawn at awards breakfast.

$100.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

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Credit Card Number	Security Code
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Please click one of the PayPal options to complete payment and submit the form.

Zena Dun Devils 2023