Registration Form

Swimmers Information:

Emergency Contact Information:

Parent / Guardian Information:

2nd Emergency Contact Information:

Medical Information:

In submitting this form as the athlete’s parent or legal guardian, I certify to PG Water Lilies Synchronized Swim Club (the “CLUB”) that all of the information provided above is true and complete.
As a member of the CLUB:

  1. I PROMISE TO OBSERVE AND FOLLOW the rules and regulations of the club
  2.  I HEREBY GIVE PERMISSION AND AUTHORIZATION TO the CLUB’s administrators, coaches or chaperons, to provide general supervision, or medical intervention they deem necessary and /or reasonable while the athlete is training / competing
  3.  I AND THE ATHLETE HEREBY RELEASE THE CLUB from any claim or lawsuit that I or the swimmer may have, against the club, as a result of injury (including death) to myself or the swimmer, or the loss or damage to our property whether or not caused by the negligence of the club.
Photo Consent: