Adjusted 24/25 Fall/Winter CST Season Enrollment Form

WEST COOK YMCA COMPETITIVE SWIM TEAM 2024/25 FALL/WINTER SHORT COURSE SEASON ENROLLMENT FORM

This registration form includes a special payment request option.
Welcome to the West Cook YMCA Competitive Swim Team for the 2024/25 Fall/Winter Short Course Season! This registration form is to participate in the swim season. Please note that Swimmers are required to be members of the West Cook YMCA as well as USA swimming to be a part of the Competitive Swim Team, this season registration form includes options to register for and sign up for needed memberships to finalize registration for the season.

For more details about the season, please visit our website landing page www.westcookymca.org/cst. If you have any questions please email us at cst-team@westcookymca.org.

Parent/Guardian Information
Parent/Guardian Name:*

First NameMiddle NameLast NameSuffix
Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian Email*
example@example.com
Name of Additional Person to add to all team communications

First NameLast Name
Email address for additional person to add to all team communications.
example@example.com
Are you interested in becoming a certified official for the swim team?

YesNo

Emergency Contact Information

We will only contact emergency contacts in a case in which parent/guardians are not available.
Emergency Contact*

First NameMiddle NameLast NameSuffix
Emergency Contact Relation*
Emergency Contact Primary Phone*

Area CodePhone Number

Membership and Parent Agreement
Membership Options- must have a card on file with the West Cook YMCA or will be contacted for payment information.*

Yes, our swimmer and/or family has a membershipI would like to upgrade to a household membership ($89/month)I would like to have our swimmer(s) to have a youth membership for each swimmer ($27/month)Our family would like to have a household membership ($89/month)I do not know if my membership is active, if not, please reactivate
I give permission for my child(ren) to have their picture and/or video taken as part of the West Cook YMCA program. I understand that the picture or video may be used for West Cook YMCA marketing and communications but not limited to using with the facility, newspapers, or other media outlets.*

Yes, I give permissionNo, I do not give permission
Parent/Guardian certifies that the applicant(s) is (are) physically able to participate in competitive swimming and/or clinic programming, and parent/guardian is in agreement with the rules governing the program, including rules pertaining to personal behavior and conduct of the swimmer(s). Parent/Guardian understands that swimmers dismissed as a result of rules violations are not entitled to refunds. Parent/Guardian authorizes the West Cook YMCA to activate swim team billing including ISI fee (if applicable and is not paid through this form) and membership options as chosen above and charge my card on file.*

Clear
Date*

MonthDayYear
Date

PAYMENT INFORMATION

Please select which program(s) your swimmer(s) will be signing up for below. For the CST season, you have the option to pay in full or a payment plan with two payments, with the first being charged today. Confirmations will be sent to all families 4-5 business days after your form is submitted.
50% of the CST tuition payment is due at time of registration, unless special request for payment is approved. Payment options include: calling the front desk or visiting the front desk and a member engagement team member will support your registration.*

Yes, I confirm that I am responsible for 50% of the CST tuition payment at time of registration. I will call or visit the front desk.I need to request an adjustment payment request.
Adjustment Payment request. Please share below the special payment request. Typically a minimum of 50% of the swim team fee is due at registration. Below please share details of your payment adjustment request. For example, if you would like to use a credit you have on file, participating in only part of the season, or would like to request an alternative payment schedule.
Should be Empty:

WEST COOK YMCA COMPETITIVE SWIM TEAM 2024/25 FALL/WINTER SHORT COURSE SEASON ENROLLMENT FORM