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Swimmer Inforamtion

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					                                   ODESSA AQUATIC CLUB (OAC)
                                   REGISTRATION AGREEMENT

I.       REGISTRATION INFORMATION

FAMILY NAME: __________________________________________________________________________________
                    Last                            Mother                    Father
ADDRESS: _______________________________________________________________________________________
                    Street
_________________________________________________________________________________________________
 City                            State              Zip

PHONE LIST
__________________________________________________________________________________________
 Home Phone
__________________________________________________________________________________________
 Father's Work                         Cell Phone
__________________________________________________________________________________________
 Mother's Work                         Cell Phone
__________________________________________________________________________________________
 Other

EMAIL ADDRESS
__________________________________________________________________________________________


SWIMMER #1
    NAME_____________________________________________________________________________
              Last                          First                   Middle
    NICKNAME: ______________________

         BIRTHDAY_____/____/_____            AGE:______________        Returning_________ New _______
                                                                                (please check one)

     SWIMMER’S SCHOOL_____________________________________GRADE_______________________

              Swimmer #1 Team Assignment: ___________________________________ (for office use only)


SWIMMER #2
    NAME_____________________________________________________________________________
              Last                          First                   Middle
    NICKNAME: ______________________

         BIRTHDAY_____/____/_____            AGE:______________        Returning_________ New _______
                                                                                (please check one)

     SWIMMER’S SCHOOL_____________________________________GRADE_______________________

              Swimmer #2 Team Assignment: ___________________________________ (for office use only)



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                                       ODESSA AQUATIC CLUB (OAC)

II.      AGREEMENT

The undersigned parent and the Odessa Aquatic Club (OAC) agree as follows:

1.       Dues
          (a) In consideration of the participation of the swimmer(s) in OAC’s competitive swim program, the
              Parent agrees to pay the dues for the Swimmer’s practice level that are set forth on the attached Dues
              Schedule. Payment shall be made on a month to month basis. Monthly payment of dues shall be due
              and payable on the first day of each month. Dues may be prepaid at any time.
         (b)  No dues will be refunded.
         (c)  If the monthly dues payment is not received in full by the 5th of the month, a late fee notice will be
                   mailed.
         (d)  If the monthly dues payment is not received in full by the 15th of the month, the swimmer will not be
              allowed to participate in any OAC functions, including, but not limited to practices and meets, until
              all outstanding dues are paid in full.

2.       Registration Forms
                Prior to participating in any club activities, the Registration Form, the Swimmers Agreement to
                Hold Harmless, and the Emergency Medical Treatment forms MUST be completed, signed and
                returned to a member of the OAC Board of Directors. Within 30 days of becoming a member of
                OAC, each swimmer MUST register with USA Swimming. Annual registration with USA
                Swimming requires a $52.00 fee paid to West Texas Swimming.

3.       Swim Team Assignments
               OAC coaches will decide, based upon each swimmer’s abilities, into which program level each
               swimmer will be placed.

4.       Swimming Meets
              All swimming meet fees and costs, including but not limited to entry and registration fees, travel,
              and hotel, are the responsibility of each swimmer. All entry fees must be paid in full prior to
              each meet. Transportation to and from swimming meets and other club activates is the
              responsibly of each swimmer and their family.

5.       Fundraising Projects
               OAC may, from time to time, conduct fundraising activities to raise money for the club. All
               fundraising activities must be approved by the Board of Directors prior to conducting ay
               fundraising activities. Fundraising actives are conducted on a voluntary basis. Although
               participation is not mandatory, we encourage participation to support OAC.




      __________________________________________                         _______________________________
      Parent or Guardian Signature                                       Date

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                                        ODESSA AQUATIC CLUB (OAC)

III.     Swimmer’s Agreement to Hold Harmless (One form per swimmer)

I, _____________________________ agree to and herby release OAC; the OAC coaching staff; (Print Name of
Parent, Guardian, or Adult Swimmer) the Ector County Independent School District (ECISD); West Texas
Swimming; and USA Swimming, Inc.; their agents and employees from all liabilities and claims arising by reason of
injuries that may occur to _______________________________________ while participating in
                                         (Print Name of Swimmer)
 the programs of the Odessa Aquatic Club including travel to and from training sessions, other scheduled activities,
and swimming meets. I agree to indemnify and hold harmless the above-mentioned, their agents and employees,
against any and all liability for personal injury, including injuries resulting in death, or damage to property, or both,
while enrolled in the program. I agree to reimburse the above for any and all damages they are compelled to pay
arising from any such claim, demand, action, or cause of action as may arise from my or my child’s action while
enrolled in the program.

IV.      Emergency Medical Treatment Authorization

I, ________________________________________, in the event that I cannot be reached to make arrangements
(Print Name of Parent, Guardian, or Adult Swimmer)
for emergency medical attention, authorize the staff and/or coaches of the Odessa Aquatic Club to take me or my
child ____________________________________to ______________________________________________
                   (Print Name of Swimmer)                        (Print Name of Physician)
or to the nearest emergency medical facility If the named physician is not available, I authorize the staff and /or
coaches to obtain emergency medical attention and treatment for me or my child at a hospital or clinic of their
choice. I give consent to the hospital or clinic and physicians to render the necessary emergency treatment to me or
my child.

Insurance Company:______________________ Policy Number:__________________________

Name of Insured:_______________________ Group Number___________________________

Known Drug Allergies;__________________________________________________________

Known Medical Conditions:______________________________________________________

Emergency Telephone Numbers:

Work: (_____)_______________________ Home: (_____) ____________________________

Mobile: (_____)_____________________

Other Family: (_____)_____________________ Friend: (_____) _______________________




 ____________________________________________                            _______________________________
 Parent or Guardian Signature                                            Date
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                                       ODESSA AQUATIC CLUB (OAC)

    V.        Fee Schedule 2006-2007

              a) Introduction to Competitive Swimming - $45.00 per month
                 OAC’s introductory program meets two (2) times per week for one (1) hour per class. This
                 program is intended for entry level swimmers and focuses on elementary fundamentals of
                 swimming and overall conditioning. Swimmers must be able to swim a minimum of 2 different
                 swim strokes for a distance of 25 yards per stroke. This is not a learn to swim program.

              b) Intermediate Program - $50.00 per month
                 OAC’s Intermediate Program meets four (4) days per week (Monday through Thursday) from 6
                 PM to 8 PM and is intended for swimmers who have mastered swimming fundamentals. This
                 program focuses on improving stroke technique, overall conditioning, and prepares swimmers to
                 enter meets.

              c) Advanced Program - $50.00 per month
                 OAC’s Advanced Program meets four (4) days per week (Monday through Thursday) from 6 PM
                 to 8 PM and focuses on competitive swimming.

OAC offers families with multiple swimmers a discount on monthly program fees. For families with multiple
swimmers, a $10.00 discount will be offered. Discounts are not available for the Introduction to Competitive
Swimming program. For swimmers joining after the first of the month, the club dues will be pro-rated for the
first month.

OAC reserves the right to modify the program schedules based on participation in swimming meets, holidays,
and other reasons approved by the Board of Directors. Note that OAC uses pools owned and operated by the
City of Odessa and the Ector County Independent School District. Schedules may be modified based on city or
school events and maintenance activities. OAC will attempt to keep members apprised of any such occurrences.




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