Prineville Swim Team Registration Form

Prineville Swim Team Registration Form

2025 Seasonal Registration
Have you registered your swimmer with USA Swimming for the upcoming season?

YesNo
Parents Name(s)

First NameLast Name
First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Do you receive text at this number? *Only used for notifications*

YesNo
Swimmer's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact
Name & Phone Number
Swimmer's Gender*

MaleFemale
Swimmer's Birthday

MonthDayYear
Date
Swimmers Age
Swimsuit Size (sizing kit available)
Sweatshirt Size
Sweatpants Size
Swimmers Preferred Name on Apparel
Please click yes if you will give permission to have photographs of your child taken for social media perposes

YesNo
How did you find us?*

Returning SwimmerFacebookFriendOther
If you were referred by a friend, please let us know who, so we can thank them!

First NameLast Name
My swimmer will join at the following level:

Beginner - $250.00 feeIntermediate - $300.00 feeAdvanced - $300.00 feeTrial Swimmer - no fee at this time
We offer a $25.00 discount per child for families with multiple swimmers!

THIS ONLY APPLIES TO INTERMEDIATE & ADVANCED SWIMMERS. NOT AVAILABLE FOR BEGINNERS.
Please add 3% to the total for online payments

(You may pay with cash or check at one of our in-person registration events for no fee)

PST Registration Fee

USDPayment Amount

Payment Method:

Paying Online & Included the 3% credit card feeI plan to pay with cash or check to avoid the fee
Please verify that you are human*

Parent Acknowledgement

	Yes/Agree
I understand I am required to volunteer at least 5 hours during the home swim meets
I understand my swimmer may NOT participate in any swim meets until his/her swim dues are paid in full
I understand PST will NOT order any swim gear for my swimmer until his/her swim dues are paid in full

We offer a $25.00 discount per child for families with multiple swimmers!