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2019-20 Carlynton Aqua Club

Carlynton Aqua Club

2019-20 Competitive Program Membership

Registration Form

Parent/Guardian Information

At least one parent/guardian registration is required.
New accounts will be sent an email confirmation message with instructions to setup a password.

At least one parent/guardian email address must be provided.
Check the boxes to indicate which parent/guardians should receive team-wide emails.

First Name * Last Name * Email Address *
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Primary Phone

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Athlete Information

Enter the information for each athlete being registered below. At least one Athlete registration is required.

First Name * Preferred Name Middle Initial Last Name * Gender * Birth Date *
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Home Address

District Resident

Carlynton District Resident? *

Parental Consent

I hereby give permission for my child to participate in the swim program and the Carlynton Aqua Club during the current swim season. Indemnification of Liability: I hereby release the Carlynton Aqua Club, the winter swim conference (WCPSL), their officers, agents, and employees from all claims on behalf of my child, myself, executor, administrators, and assigns that may result from injuries received from the swimming season. Physical Readiness: I believe that the above information is complete and accurate and that there is no reason that my child would not be physically capable of participating in the Carlynton Aqua Club's swim team to the fullest extent.

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Enter your initials to indicate acceptance: *
Swimmer Code of Conduct

(A copy of this document can be found here)

I have read the CAC Swimmer’s Code of Conduct. I understand that respectful and sportsman- like behaviors are an important part of being a member of CAC. I agree to adhere to the principals put forth in the Code and I understand that failure to do so can result in my being dismissed from the team.

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Enter your initials to indicate acceptance: *
Parent Code of Conduct

(A copy of this document can be found here)

I have read the CAC Parent's Code of Conduct. I understand that, as a parent, it is my responsibility to show respectful and sportsman-like behaviors as an example to my children. I agree to adhere to the principals put forth in the Code and I understand that failure to do so can result in disciplinary actions.

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Enter your initials to indicate acceptance: *
Photo Release Form

I give permission for representatives of the Carlynton Aqua Club to take photographs of my child(ren) in connection with club-related activities. I authorize Carlynton Aqua Club to use the same in print and/or electronically.

Enter your initials to indicate acceptance: