Woogaroo Swim Club Registration | Competitive Swimmer Form

Please Select one*

I am new to Woogaroo Swim ClubI am renewing my Woogaroo Swim Club Membership

Please upload Copy of Swimmers Birth Certificate*

Browse Files

Full Name*

PrefixFirst NameLast Name

Date of Birth*

Date

Gender*

MaleFemale

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Phone Number*

Area CodePhone Number

E-mail*

Member Type (Position in Family)*

Competitor 1Competitor 2Competitor 3Competitor 4

Coaches Name*

First NameLast Name

Other

Web Access User ID

Password

Emergency Contact*

First NameLast Name

Emergency Contact Phone*

Area CodePhone Number

1. Getting Started Vouchers will only be accepted under approval by the Executive Committee and must be provided to the club, prior to sign on and before the first carnival or club night of the season that the swimmer competes in.

DECLARATION 1
Conditions of being a Member of Swimming Queensland, Affiliated Regions and Clubs
I agree to abide by the rules, regulations and policies of swimming Qld, Swimming Australia, the relevant Regional Swimming Association and Woogaroo, including Swimming Australia’s Anti-doping, Member Welfare, Child Welfare and Privacy Policy that are available through www.swimming.org.au.
I authorise Swimming Qld to use and disclose, to related and relevant bodies any of my personal information that may be necessary to implement the rules, regulations and policies above. I agree to have my name and results published in official programs, newsletters and websites.
Please note that the club as an affiliate of Swimming Qld has $20 million public liability insurance cover. I fully understand that the Swimming Australia National Insurance Programme includes a limited level of cover in the event of personal injury. I understand that only non-medicare medical expenses to a maximum of $5000 can be claimed. If the medical serve provided in eligible for a medicate rebate of any valve, any resultant GAP in costs is not able to be covered by Swimming Australia policy due to current Commonwealth Legislation. For further information on the insurance cover available refer to 1800 373 130.

DECLARATION 2
Parent / Legal Guardian Consent for an applicant under 18 years
Where the applicant is under 18 years of age, this form must be endorsed by the applicants parent or legal guardian.
I have read, understood and agree to the declaration above and warrant that all information provided is true and correct.
I, as parent or guardian of the applicant, expressly agree to accept responsibility for the applicant’s behaviour and agree to personally accept the conditions set out in the application and declaration.

Competitive Swimmer Details