1. Athlete Information

Student Name*_________________________Student ID Number_____________

Date of Birth_________________Grade_______Male_______Female________

Swimmer____Diver____Both____ Name of Club/SummerTeam: ____________

*names/photos may be published on our website. If you DO NOT want your athlete’s name/photo on our website, initial here__________. If this line is NOT initialed we assume we have your permission.

2. Parent/Guardian Contact Info.

Names___________________________Parents’ E.mail____________________

Address__________________________________________________________

Phones: Home_________________Work________________Cell____________

3. Fees: $210.00 per athlete

Fees are used to pay for pool rental for practice and meets, officials, meet fees, team t-shirt, sweatpants, team cap, team equipment and swim meet supplies, awards, ect. Extra donations are welcome. Make checks payable to: Shiloh Swim & Dive Booster Club.

Total Included= ___________

cash ______

check # _______ Visa/MC # ____________________ exp.date______

T-Shirt size: S M L XL Sweat pant size: S M L XL

4. Swimsuit/Spiritwear Purchases: These items are sold separately. Please use the Spirit wear order form to place your order. Only the team swimsuit and goggles are required, but other items are available with our team logo. Returning swimmers/divers may use their suits, spirit items from previous years if in good condition.

5. Required Parent Involvement Information

As a swim/dive parent we need your assistance to make this season successful

Please number your preferences (1-6) as a commitment to be a timer/runner.

(If everyone does their part we will only need you for your top 3 picks max.)

___Sat. Nov.14 7:45am ___ Fri. Jan.8 6:30pm

___Sat. Nov.21 7:45am ___Fri. Jan.15 6:30pm

___Fri. Dec 4 6:30pm ___ Sat. Jan.23 7:30am

___Sat. Dec.12 8:30AM ___Jan. 27-30 County-tba

We also need a parent willing to organize one of our major events/functions

Please circle if you are willing to lead or assist in 1 of the following areas:

Team Banquet Senior Night Computer Entry

Team Video Fundraising Head Timer/Coordinator