2024 SNS FALL LAUNCH CAMP

Medical Authorizations
Athlete Name*

First NameLast Name
Primary Parent Name*

First NameLast Name
Primary Parent Phone Number*
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Secondary Parent Name

First NameLast Name
Secondary Parent Phone Number
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Emergency Contact*

First NameLast Name
Emergency Contact's Relationship to Swimmer*
Emergency Contact's Phone Number*
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Physician Name

First NameLast Name
Physician's Phone Number
Please enter a valid phone number.
Medical Insurance Carrier*
Policy Number*
Upload a Photo of Your Medical Insurance Card*
Please tell us, in confidence, of any medical condition(s) your child has that we should be aware of (i.e., allergies --especially food allergies -- medications, disabilities, etc.)
MEDIA NOTICE:
By participating in this Camp, the athlete or his/her guardian consents to the publication, via electronic, print or other media, information and/or imagery related to their participation at this Camp. Such information and imagery may include, but is not limited to, photographs, video, web casting, television, psych sheets and live meet results.

MEDICAL AUTHORIZATION
I hereby authorize, consent and direct the Sierra Nevada Launch Camp Staff, its directors, officers, and employees, and any physician, hospital, or other health care provider selected by the Sierra Nevada Swimming, to take such action as is necessary in the circumstances to provide emergency care and related treatment to my above-named child in my absence, should the need arise while he/she is participating in the programs of Sierra Nevada Swimming. I hereby designate Sierra Nevada Swimming, its directors, officers, and employees as my authorized agent for the signing of any consent forms required by any such health care provider in connection with such health care.
Parent/Guardian Signature*

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SIERRA NEVADA SWIMMING HONOR CODE
Each athlete or staff member of any team representing Sierra Nevada Swimming during any LSC sponsored event (which includes travel to the meet/camp, the duration of the competition, as well as travel back from the meet) is required to sign Sierra Nevada’s Swimming Honor Code. All issues as set forth within the Honor Code apply to all athletes, officials, coaches and adult chaperones unless otherwise designated.

I, as a member and/or participant of Sierra Nevada Swimming understand and will comply with the following as approved by the Sierra Nevada Swimming Board of Directors:
1. The possession by any Athlete or the use of alcohol, tobacco products, or controlled substances is prohibited throughout the event.
2. As an adult representative of Sierra Nevada Swimming as a Coach, Parent Chaperone or Official, the possession of a controlled substance is prohibited throughout the participation of the trip. Additionally, there will be no use of alcohol or tobacco products around the swimmers at any time.
3. Curfews will be established and adhered to during the trip.
4. As to all Athletes, attendance is required at all team functions which include, but are not limited to, meetings, practices, exhibitions, press conferences, and competitions unless otherwise excused or instructed by the head coach, the head chaperone, or designated person in charge of the team.
5. As to all adult chaperones, attendance is required at all team functions which include, but are not limited to, meetings, practices, exhibitions, press conferences, and competitions unless, otherwise excused or instructed by the head chaperone, or designated person in charge of the team.
6. As to all coaching staff and adult volunteers the Head Coach is in charge of all issues relating to the conduct of the camp and attendance by the Athletes. Any and all questions or concerns are to be brought to the attention of the Head Coach. All decisions made by the Head Coach are final and are to be followed.
7. As to all adult chaperones, the Team Manager is in charge of all issues relating to the supervision and control of the Athletes with the exception of those matters that fall within the Head Coach’s authority. Any and all questions or concerns are to be brought to the attention of the Team Manager. All decisions made by the Team Manager are final and are to be followed. By agreeing to attend the meet as a chaperone, you understand and agree that you will not be allowed to chaperone your child or their age group.
8. With the permission of the adult chaperone, male and female athletes may be in the same room as long as the hallway door remains open.
9. Uniform requirements that are established for the trip will be followed.
10. Proper respect, sportsmanship, and courtesy toward coaches, officials, administrators, competitors, chaperones and the public will be displayed at all times.
11. The manner by which one behaves will present a positive image of Sierra Nevada Swimming and will provide an atmosphere to meet the competitive performance objectives.
12. Additional guidelines may be established as needed to assure the safety and well being of the team members and will be adhered to during the trip.
I understand that failure to comply with the Sierra Nevada Honor Code as set forth in this document or additions necessary for the safety and well being of the team members may result in disciplinary action, which may include but is not limited to the following:

As to Athletes:
1. Disqualification from one or more events of the competition/camp.
2. Dismissal from the team and return home at my own expense.
3. Reimbursement of all expenses paid by Sierra Nevada Swimming on your behalf relating to this trip.
4. Disqualification from future Sierra Nevada Swimming sponsored activities pending LSC Board of Review.
As to All Coaches, Officials and Adult Chaperones:
1. Dismissal from the camp and return home at my own expense.
2. Reimbursement of all expenses paid by Sierra Nevada Swimming on your behalf relating to this trip.
3. Disqualification from future Sierra Nevada sponsored activities pending LSC Board of Review.
Event: 2024 SNS Launch Camp | Event Date: Sunday, October 27, 2024
Athlete Signature*

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Parent Signature*

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2024 SNS LAUNCH CAMP

General Information

Athlete Information

Parent Information

Medical Authorizations

SIERRA NEVADA SWIMMING HONOR CODE