Mobile Advertising Agreement Form - DOC by gzh11418


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									                    City of Mobile Swim Association

                                     P.O. Box 1207
                                  Mobile, AL 36633-1207

                                   Phone: (251) 648-3977


                              Welcome to CMSA!
We are happy that you have decided to become a member of the City of Mobile Swim
Association. CMSA is a year round competitive swim team offering instruction to young
people of all ages and abilities. Please do not hesitate to call the office if you have any
questions. You will find the web site at a tremendous tool in keeping
abreast of CMSA happenings. Check it out often. You can also contact the coaches using e-

   I.     Please use the following list for initial fall registration
          a. Turn in a check for registration fees and first month dues or register and pay
          b. Turn in the following forms (labeled on the top of each page)
             Form #1. CMSA Registration Agreement Form
             Form #2. Medical Information and Consent Form
             Form #3. Financial Agreement Form
             Form #4. Code of Conduct Form

   II.    You must include the CMSA registration fee per Dues Structure enclosed ($100
          per swimmer, which includes USS Swimming Registration for insurance purposes,
          CMSA t-shirt, and1 CMSA team cap. Make your check payable to CMSA.

   III.   Important Billing Information – CMSA bills in a nine month cycle. The summer
          months are free if you have paid a full nine months. All swimmers that join after
          December 2010 will be billed for the summer months.

                                         Page 1 of 8
                                                                                                   [Form #1 of 4]

                                  REGISTRATION AGREEMENT FORM

FAMILY NAME: ________________________________________________________
                         (Last)                      (Mother)                     (Father)

ADDRESS: ____________________________________________________________

(City)                      (State)      (Zip)       (E-mail Address – print clearly)

PHONE: ______________________________________________________________
            (Home)                              (Work)                             (Cell Phone)

(Last)                                (First)                      (M.I.)            (Preferred)

BIRTHDAY _______/_______/_______ Age: _______

T-Shirt Size (circle one): YS           YM      YL        AS      AM        AL


CMSA Practice Team (Circle One):

Guppies      AGE I           AGE II      AGE Elite       Junior   Senior         Senior 1

(Last)                                (First)                      (M.I.)         (Preferred)

BIRTHDAY _______/_______/_______ Age: _______

T-Shirt Size (circle one): YS           YM      YL        AS      AM        AL


CMSA Team (Circle One):
Guppies     AGE I           AGE II       AGE Elite       Junior   Senior         Senior 1

                                                         Page 2 of 8
                                                                                                         [Form #2 of 4]

                           City of Mobile Swim Association
                               Medical Information and Consent Form
                                     (One Form per Swimmer)
Swimmer’s Name: ______________________________________________________

Parents’ Names: ______________________________________________________

Home Phone: __________________________ Cell Phone: __________________________

Parents’ Work Phone(s): ______________________________________________________
1. In the space provided, please list any pertinent health or medical information and instructions or special
problems (allergies, prescriptions, existing health issues).

2. Aside from yourselves, please indicate (in order) those individuals that you would like the coaches to contact
should there be an emergency involving your child.



3. Swimmer’s Doctor and Phone: _______________________________________________
I (we) hereby give permission for _______________________________ to participate in practice, swim meets,
and all other CMSA team activities throughout the course of the current season. In no event will the City of
Mobile Swim Association, its’ officers, coaches, or agents be held liable for any first aid rendered or treatment,
drugs, medicines, or surgical procedures performed pursuant to this consent. Additionally, I (we) do hereby
release and forever discharge any and all rights and claims for damages which we, or either of us, or my (our)
child, may hereafter have against the City of Mobile Swim Association, its officers, coaches, employees, or
agents, and/or suffered by me, my spouse, or my (our) child in connection with any CMSA practice, meet, or
activity, or travel to or from such events. In consideration for your allowing myself or any family member to
participate in any City of Mobile Swim Association program, I hereby release the City of Mobile Swim
Association and all affiliated associations, together with their respective trustees, directors, officers, employees,
and agents, of or from any and all demands of any kind or nature whatsoever arising out or in any way related
to the above named participation in the City of Mobile Swim Association. THIS IS A FULL RELEASE OF
To the Attending Physician or Hospital:
Permission is hereby granted for you at the discretion of the CMSA coaches or representatives to perform
whatever care is necessary for the welfare of my child until such time as you are able to reach me personally.

Insurance Information (MUST BE COMPLETE)
Subscriber’s Name (Parent): ____________________________________________________

Insurance Company: ____________________________________________________________________

ID and Group Number:      _______________________________________________________

(Parent/ Guardian Signature)                              (Date)

                                                       Page 3 of 8
                         City of Mobile Swim Association
                               Monthly Dues Structure (2010-2011)
The City of Mobile Swim Association bills on a monthly cycle. Upon registration, participants commit to paying
program fees until 30 days notice is given to end membership. You are obligated for these fees until you
cancel participation. See “Financial Agreement.”

Early Registration Discount - $20 off for early registration for competitive groups only. Early
registration ends on July 31, 2010.

A family with multiple swimmers in any of the CMSA competitive programs (Age I through Senior) will pay
Registration Fees as follows:
                                                 1st Child           $100
                                                 2nd Child           $100
                                                 3rd Child            $75
                                           Each Child thereafter      $55

The CMSA Swim School and any clinic or league program is considered a non-competitive program (Guppies &
Senior One) and is exclusive of these discounts. There shall be no discount for multiple swimmers in any of the
non-competitive programs ($75 registration/swimmer).

For more information about CMSA's financial policies, please refer to the Financial Agreement. All fees are
billed for nine months unless the swimmer joins after December 2010.

            Group Name                       Swim Dues                   Fundraising**       Fee***
            Guppies                          $50 / month                      None              $75
            AGE I                            $95 / month                      $225             $100
            AGE II                           $95 / month                      $225             $100
            AGE Elite                        $110 / month                     $225             $100
            Junior                           $115/month                       $225             $100
            Senior                            $85/month                       $225              $75
            Senior                           $130 / month                     $225             $100

       When registering you will pay the registration fee and first month dues with a check
       All monthly dues and fundraising amounts (after the initial fees) will be deducted on automatic bank draft.
        Thirty days written notice must be given to be removed from automatic bank draft.
        Fundraising for the year is due by May 15 . If fundraising is not paid by this date, the amount will be
        automatically withdrawn with monthly dues on June 20 . If you give 30 days’ written notice and have not
        met your fundraising commitment, you will owe the amount of fundraising prorated to the months
       Swimmers that join the team after December 2010 will be billed for the summer months of CMSA.
        Registration Fee is due August 15th. There is a $20 discount for all registrations turned in before July 31 .
        This does not apply to High School or Guppies.

Fundraising is designed to help limit the out of pocket expenses for swimmer’s families. CMSA provides fund-
raising as a way to keep session fees as low as possible. The Fundraising requirement may be met by any
combination of advertising, team-organized fundraisers, and/or purchasing Scrip. Payments are made through
fund-raising activities or paid out of pocket. If out of pocket option is selected, a $25 per month amount is
added to the monthly Dues via Bank Draft. Please be sure to elect this option during online payment

                                                    Page 4 of 8
Registration Fees are due upon joining CMSA and in return your swimmer will receive a USS swimming
registration, 1 t-shirt, 1 CMSA team cap, and Splash Magazine subscription.

                                     CMSA Billing Calendar

                  July 31, 2010                             Last day for “early” registration discount

                 August 16, 2010                            All registration forms must be turned in
                                                            (Registration fee with first months dues)
                                                               August 16th – First day of practice
                 September 19th                                         Debit for October

                   October 19th                                       Debit for November

                 November 19th                                        Debit for December

                  December 19th                                         Debit for January

                   January 19th                                        Debit for February

                  February 19th                                         Debit for March

                    March 19th                                           Debit for April

                    April 19th                                           Debit for May

                     May 19th                          Debit for June (This debit is for swimmers that
                                                                joined after December 2010)

                     June 20th                         Debit for July (This debit is for swimmers that
                                                                joined after December 2010)

                     June 20th                           All outstanding fundraising will be debited

                                              Page 5 of 8
Each CMSA family with a competitive swimmer (not Guppies/Senior I) is responsible for meeting the fundraising
requirement of $225 for the 9-month period beginning September 1 and ending May 15. Families may choose
how they would like to meet their fundraising requirement by:

                Option 1 - Fundraise by using any combination of advertising, Swim-A-Thon, other
                            fund-raisers, and/or purchasing SCRIP.
                Option 2 – Monthly out-of-Pocket donation via Bank Draft

If a family does not meet 100% of their fundraising commitment for the 9-month period, any delinquent amounts
are due at the end of this period and will incur an additional one-time Bank Draft on June 20 All dues and fees
are due before their swimmer can begin the next season. Swimmers shall not be allowed in the water until
proper verification of payment has been made by Coach. CMSA Coaching Staff will maintain fundraising
records with a list of families and amounts during each season.

Advertising Web Page:
Ad on the Web will run from September 2010 – September 2011. The time the ad will be displayed will be
based on the time the ad copy is received. Because of the time that is required to have the ads ready for the
Web, they may not be posted immediately, but will be posted as soon as possible. Our Web site address:

The Ad must be submitted electronically via CD or email.
   1. Web Site Ad Only                      $200
   2. Web Site Ad + Link to the Site        $300

Advertising Heat Sheets:
The advertisements are placed in programs called “Heat Sheets” that are available during meets. During the
season CMSA will host or co-host at least 3 meets. In order for your advertisement(s) to be published in the
Heat Sheets for the season we must receive your Ad copy by November 1. If advertising is received after this
date it will be published in the remaining Heat Sheets.

Ad Rates (this amount covers all CMSA-hosted meets):
   1. Full Page:       $100
   2. Half page:       $70
   3. Quarter Page: $50
   4. Eighth Page: $30

All ads are subject to the approval of the Board of Directors.

Other CMSA Fundraisers:
Wintzell’s Oyster House Gift Cards
SCRIPT (giftcard purchases)
Cookie Dough Sales
Spirit Store
And other fundraisers will be announced throughout the year.

                                                   Page 6 of 8
         City of Mobile Swim Association                                                 [Form #3 of 4]
                                         FINANCIAL AGREEMENT

The undersigned and the City of Mobile Swim Association (CMSA) agree as follows:
1. Dues
  (a) In consideration of the participation of the swimmer(s) in CMSA’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.
       Payments will be paid monthly through our CMSA Website Company (Team Unify) after the initial
       registration fee and first months dues.
   (b) Families who join CMSA in mid season will be required to follow normal registration procedures. Families
       who join after December 2010 will be responsible for summer monthly dues.
  (c) If the swimmer is transferred to another training group by the coaching staff, the new group rate will take
       place starting the next month.
  (d) Upon registration, participants commit to monthly dues & fees, regardless of the extent of
       participation during the time of payment. Participants are assumed to be continuing on for the next
       month unless the club Treasurer, Head Coach, or Head Age Group Coach is notified in writing (30 days
       notice) of the swimmer's withdrawal and notification to cancellation of membership.
  (e) A family with multiple swimmers in any of the CMSA competitive programs (Age Group I through Sr. Elite)
       will pay a registration fee of $100 for the 1st child, $100 for the 2nd child, $75 for the 3rd child, and $55
       for each child thereafter. The CMSA Senior One/Guppies and any clinic or league program is considered
       a non-competitive program and is exclusive of these discounts. There shall be no discount for multiple
       swimmers in any of the noncompetitive programs. The non-competitive registration fee is $5/swimmer.
  (f) Each first time CMSA swimmer is entitled to a one-week free trial for any of the competitive teams. This
       trial is for first time CMSA swimmers only.
  (g) A $30.00 Late Registration Fee will be charged to any family submitting payment more than 10 days after
       the start of each season.
  (h) Fees for meet entries and surcharges are separate from program fees and have a policy outlined in the
       Parent Handbook. Swimmers must be in good financial standing in order to be able to participate in
  (i)A family will not be able to register a child to swim with the City of Mobile Swim Association for the
       upcoming season until all financial obligations for the previous season have been met (Session fees,
       Registration, Fundraising).
2. Fundraising Requirements
  (a) The fundraising commitment may be fulfilled through Advertising, Scrip, Swim-A-Thon, and various
       fundraisers (cookie dough, spirit store, & golf tournament). The 9-month fundraising obligation is due May
       15 . If a family does not meet 100% of their fundraising commitment for the 9-month period then any
       delinquent amounts are due at May 31 and will incur an additional one-time Automated Bank Draft
       charge on June 20 for the remaining amount. The fundraising fee will be prorated if a swimmer gives 30
       days written notice of resignation during the middle of the season or joins in the middle of a season. Any
       family that has not met its fundraising commitment by the end of the season will not be able to
       register for the following season.
  (b) Heat Sheet Advertising will be due eight days prior to a home swim meet. If heat sheet advertising is
       received after this date, the ad will be published in the remaining heat sheet(s). Payment for copy is due
       at time of receipt.
  (d) Fundraising Obligations are due until the family has notified CMSA in writing 30 days prior that a
       swimmer has withdrawn from the program or membership has been cancelled. The family is responsible
       for a prorated portion of the Fundraising obligation through the end of the period for which the family is
       responsible for program fees.
I have read and understand the Dues Structure & Financial Agreement and agree to abide by it.

___________________________              ______________________                   ______________
(Signature)                                   (Print Name)                             (Date)

                                                   Page 7 of 8
                                                                                                                 [Form #4 of 4]
                             City of Mobile Swim Association
                                          CODE OF CONDUCT FORM
The purpose of this conduct policy is to insure that every swimmer is provided an environment, which allows them the
opportunity to reach their individual goals. Therefore, underlying this policy are the following assumptions:
        o A swimmer’s conduct at practice and at swim meets should support every other swimmer’s ability to learn.
        o A swimmer’s conduct at practice and at swim meets should support the coach’s ability to teach other
        o Each swimmer should be committed to striving for their goals and for the good of the team .

Conduct Expected of All Swimmers
Swimmers are encouraged to learn because they choose to do what is in their best interest, not to avoid punishment for
“breaking rules.” However, it is in everyone’s best interest for basic rules to be clear and unambiguous.
1. CMSA swimmers are expected to remember that at practice, during swim meets and in public they are representing
    CMSA. Swimmers, coaches, and parents should represent the CMSA name with excellence, team spirit, good
    sportsmanship, and politeness.
2. CMSA swimmers are expected at all times to follow the directions of any member of the coaching staff and any person
    who is a chaperone. Disrespect or failure to obey instructions will not be tolerated from any athlete.
         a. CMSA swimmers are expected to use appropriate language. Use of profane or abusive language or obscene
              gestures will not be tolerated.
         b. There shall be no drinking of alcohol, use of tobacco products, illegal drugs, or any substances banned by
              FINA or IOC.
         c. CMSA swimmers are expected to respect each other. Fighting, intentional touching, or striking another athlete
              will subject the swimmer to the most severe discipline.
         d. CMSA swimmers are expected to respect and care for the property of others. Vandalism, intentional damage
              to property, or theft of property will not be tolerated.
         e. Swimmers may leave practice only with the coach’s permission.
         f. Disruption of practice by an athlete will be grounds for removal. (Continual cheating in a practice will be
              considered a disruption of practice.)
         g. Changing of clothes (either into or out of swimsuits) other than in designated dressing areas or bathrooms, is
              strictly prohibited. No swimmer shall change clothes while on the pool deck or in other public areas.
         a. Focus on every drill and every set.
         b. Follow all of the coach’s orders completely and exactly. If any clarification is needed, inquire politely.
         c. Never stop during a drill or set (other than the proper rest periods) for any reason. If you must go to the
              restroom or get a drink of water, ask for permission between sets.
5. DISCIPLINE: Failure to follow the above rules may result in disciplinary measures, including:
         a. Suspension from practice.
         b. Suspension from team.
         c. Expulsion from the team.

A swimmer’s first offense may warrant a one-day suspension from practice and the notification of the swimmer’s parents. A
second offense may warrant a three-day suspension from the team, and the swimmer and parents will have to meet with the
coach at the coach’s earliest convenience to be reinstated. A third offense may result in expulsion from the team. This
expulsion may be appealed to the Board of Directors. The nature or severity of the conduct may warrant more severe
discipline. Furthermore, suspension from school may constitute grounds for suspension from practice during the term of any
such suspension. Furthermore, expulsion from school may also warrant suspension or expulsion from practice or from the

Swimmers are expected to follow the spirit of the rules as well as the specific rules. The coach must adapt this philosophy to
an infinite number of situations. Swimmers are asked to respect the coach’s directions and give their full cooperation.
Cooperation with teammates and staff will produce a productive practice environment for all. The spirit of the above rules is
to provide a safe and effective training situation.

This code shall be in force and in affect for all CMSA swimmers during practice, during swim meets, and at events
sponsored by or in which CMSA participates.
I have read the CMSA Code of Conduct and discussed it with my son/daughter. We understand and agree to abide by it.

_________________________             _________________________________                _____________________________
Swimmer’s Last Name                            Swimmer’s Signature                            Parent’s Signature
                                                           Page 8 of 8

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