2019-20 Wobbegongs Season Registration

2019 - 2020 Wobbegongs Family Registration Form
Family Contact Details
Parent Guardian 1 Name *

First Name Last Name
Parent Guardian 1 Email *
example@example.com
Parent Guardian 1 Phone Number

Leave blank Mobile Number - no spaces
Parent Guardian 2 Name

First Name Last Name
Parent Guardian 2 Email
example@example.com
Parent Guardian 2 Phone Number

Leave blank Mobile Number - no spaces
Medical and Emergency Contact Name *

First Name Last Name
Emergency Contact Relationship *
Emergency Contact Mobile Number

Leave blank Mobile Number - no spaces

Child Registration Details

Season Registration Contribution - 1 Child ($80), 2 Children ($95), 3 or more Children ($110) and Pups i.e. no timed races ($30 per child)
Child 1 Name *

First Name Last Name
Child 1 Date of Birth *

Day Month Year
Date
Child 1 Gender *
Child 2 Name

First Name Last Name
Child 2 Date of Birth

Day Month Year
Date
Child 2 Gender
Child 3 Name

First Name Last Name
Child 3 Date of Birth

Day Month Year
Date
Child 3 Gender
Child 4 Name

First Name Last Name
Child 4 Date of Birth

Day Month Year
Date
Child 4 Gender
School/s Attended (WSS, HC, SMoC etc)
Medical Conditions (if any) of my child/ren

Payment of Contribution

Season Registration Contribution - 1 Child ($80), 2 Children ($95), 3 or more Children ($110) and Pups i.e. no timed races ($30 per child)
Payment Method *

Cash - sign on and club nights only EFTPOS - sign on and club nights only Direct Deposit - Ref. WWSC-Surname, BSB 064-114 Acc 10189711 Email receipt to wobbegongs.wss@gmail.com

Volunteering -
The Wooloowong Wobbegongs swim club relies entirely on the generosity of its member families for the running of club nights, carnivals and other events. All member families will be rostered to perform volunteer duties throughout the season. A draft roster will be circulated at the beginning of both Terms 4 and Term 1. Families unable to assist on their scheduled night will be responsible for swapping with another family to a more suitable date.
My preferred volunteering activities are - (use CTRL to select multiple answers) *
(we will try to accommodate your preferences however from time to time you may be required to assist in other activities so we can ensure we are sharing the load amongst the Wobbies community)

Please read and check each box below to confirm your understanding and agreement of the below club regulations -

As a parent/guardian I give consent for my child/children to participate in the swim club activities.

I agree to abide by the Club rules which I acknowledge is available to me on the swim club website.

I acknowledge that my child/children must be accompanied and supervised by an adult (parent/guardian or authorised person) for the duration of the club night. Children who are not accompanied and supervised by an adult during club night, cannot compete.

I agree that while WWSC officials and WSS P&C Association will take all responsible precautions to provide a safe venue for my child/ren, the officials will not be held liable for any personal injury or damage to property which may occur during or arising out of the presence within the confines of the pool area of any person whatsoever.

I accept full responsibility for my child/ren whilst on WSS premises.

I give permission for WWSC to publish results / information / photos of my child/ren on the club's website, in social media and from time to time for publicity for club nights and carnivals.

I agree to indemnify and keep indemnified the officials, officers and any other persons or parties undertaking activities on behalf of WWSC in connection with medical attention for my child/children, against any loss or expense as a result of any activities and outgoings incurred relating to the club.
BY CHECKING THE ABOVE BOXES AND SUMBITTING THIS FORM YOU AGREE TO ABIDE BY THE RULES OF THE CLUB AND TO PROMPTLY PAY THE CONTRIBUTION FEE TO THE CLUB BY THE METHOD SELECTED ABOVE IN PAYMENT.

YOU ALSO AGREE TO ALLOW YOUR CHILD WITH A SPECIFIED MEDICAL CONDITION TO SWIM THE SEASON WITH THE ABOVE LISTED MEDICAL CONDITIONS.
*
Should be Empty:

2019 - 2020 Wobbegongs Family Registration Form

Family Contact Details

Child Registration Details

Payment of Contribution

Volunteering -