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Membership Information

Lantana Lightning

 Information only --------------------------------------------------------------------------------------register online!!!!
SWIM TEAM REGISTRATION FORM
         Swimmer                      Age                 DOB               M/F                 T-shirt
                          

   1. ____________             _____             ________        ____                ______                                 

    2. _____________          _____              ________        ____                ______
 
    3. _____________          _____              ________        ____                ______
 
 
·          Final registration fee is $165 for each child. That will include all meets (including divisional and all-stars), and a t-shirt for the swimmer.
·          Amt paid___________ check #__________ (Make check payable to Lantana Lightning)
·          Last name_______________________________________________________
·          Father’s name_________________ Mother’s name_____________________
·          Address_________________________________________________________
·          Home Phone #______________ Cell Phone #___________________
·          E-mail________________
·          Emergency Contact (name)_______________________Phone #___________
·          Family Doctor__________________________________ Phone #__________
·          Each family is REQUIRED to serve on at least one committee. Please indicate your 1st, 2nd and 3rd choices:
·          _____ Ribbon Writing/Runner _____ Timers _____ Age Group Coordinator
·          _____ Spirit T-shirts/sponsors _____ Meet Card Coordinator        _____ Scoring
·          _____ Ready Bench                 _____ Hospitality/Equipment (home)       
·          Are you or your business interested in becoming a sponsor? Yes or No
·          Read and sign:
·          We, the undersigned, parents or legal guardians of _______________________________ (hereinafter referred to as “Applicant”), in consideration of Applicant’s participation in the instruction and recreational programs of Lantana Swim Team, do hereby agree to assume all responsibility for the risks, liabilities, and hazards incidental to Applicant’s participation in the instructional and recreational programs of the Lantana Swim Team and, furthermore, do hereby release, forever discharge and hold harmless the Swim Team Committee and the Lantana Community Association, Inc. and its officers, directors, employees, agents and members (present, past and future) from and against any and all claims, costs, causes of action and liabilities for illness and personal injury resulting from or in connection with Applicant’s participation in such programs or activities.
·          Signed ________________________________________         Date__________________________________________