Mt. Pleasant Aqua Club

Registration

Winter 2010

Accepting all swimmers at all levels

Registration: January 4^th, 5^th, 11^th, from 5:30 pm to 8:00 pm
and on the 9^th from 10 am to Noon at the Mt. Pleasant Area High School Pool.

Fees: $90.00 first swimmer === $80.00 for the second === $30.00 for the third

Make checks payable to MPAC

FUN fund raising activities will take place during the season.

Details will be provided as soon as possible.

Swim Meets: Optional, not a requirement - Usually held on Saturdays - 4 to 5 meets per season.

Parent participation is mandatory to assist in running meets.

Practice Times: Held on Monday, Tuesday, Thursday and Saturdays (when no meet is scheduled) beginning on January 4^th and ending late March - swimmers are not required to be at all practices

1^st session

Monday, Tuesday, and Thursday 5:30 pm - 6:30 pm
Saturday 11:30 am -12:30 pm

This session is for swimmers requiring stroke fundamentals

2^nd session

Monday, Tuesday and Thursday 6:30 pm - 8:00 pm
Saturday 10:00 - 11:30 am

This session is for swimmers of a more competitive nature

A parent/legal guardian is required to be present during practice with any swimmer under the age of 9.

The Mt. Pleasant Aqua Club DOES NOT provide insurance for any participant in the aqua club program. The undersigned parent or guardian represents that the swimmer is in good health and able to participate in swimming practices and competitive swimming. He/she hereby releases the Mt. Pleasant Aqua Club and its officers from any and all responsibility for an injury to the above swimmer while he/she is participating in this activity.

Website: www.mtpleasantaquaclub.com

Questions - Please feel free to call:

Greg Pimental, President ---    724-204-4088

Donna Phelan, Vice President -- 724-628-8097

Tina Edwards, Treasurer -- 724-925-2004

Andrea Billey, Secretary -- 724-423-1673

Mt. Pleasant Aqua Club

Registration

Winter 2010

Accepting all swimmers at all levels

Only 1 child per form

NAME ____________________________________________________________ M/F

DOB _______________________________ AGE AS OF MARCH 31, 2010 ______________

ADDRESS ___________________________________________________________________

___________________________________________________________________

PARENT/LEGAL GUARDIAN __________________________________________________

PHONE _____________________________________

CELL PHONE _____________________________________

WORK PHONE _____________________________________

E-MAIL _____________________________________

EMERGENCY CONTACT ___________________________ PHONE ___________________

Please list any medical conditions/allergies that your child may have and list any medications that are applicable:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

The Mt. Pleasant Aqua Club DOES NOT provide insurance for any participant in the aqua club program. The undersigned parent or guardian represents that the swimmer is in good health and able to participate in swimming practices and competitive swimming. He/she hereby releases the Mt. Pleasant Aqua Club and its officers from any and all responsibility for an injury to the above swimmer while he/she is participating in this activity.

I/We grant the Mt. Pleasant Aqua Club permission to use picture(s) of the above listed swimmer taken for the express use of the Mt. Pleasant Aqua Club on its website for promotion of the club.

SIGNATURE OF PARENT OR GUARDIAN: ___________________________________