Swimmers Full Name *

First Name

Last Name

Swimmers Birth Date *

MM

DD

YYYY

Parent/Guardian(s) Name (First/Last) *

First Name

Last Name

Parent/Guardian Cell Phone *

(###)

###

####

Cell Text enabled? *

Yes

No

Other phone (optional)

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Doctor Phone # *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone # *

(###)

###

####

Name *

First Name

Last Name

Does your swimmer have a current USA Artistic Swimming Membership for September 2024 - August 31, 2025 *

Yes

No, I will pay the extra $20

New to Artistic Swimming

Select your session and clinic level *

Your swimmer can sign up for multiple sessions

New to Artistic Swimming 1X/wk

Prior Synchro/Artistic Swimming (Intermediate) Experience

Session 1 High School Conditioning

Session 2 High School Conditioning

Name *

First Name

Last Name

Payments are expected to be on time, prior to the beginning of the session. * *

I agree to pay my bill in full prior to the start of the session my swimmer is registered for.

I agree with the MNS Financial Policy written above *

I agree and understand the MNS Financial Policy

I agree to bring my payment with checks written to "Minnesota Synchronettes or MNS" *

I agree to bring my payment to the first practice of my swimmers session.

Parent or Guardian Signature *

First Name

Last Name

Name *

First Name

Last Name

1. I understand that I will be engaging in activities that involve risk of contracting Covid-19, serious injury, including permanent disability and death, severe social and economic losses and other loss including damage to property. *

Yes, I understand.

2. I knowingly and freely assume all risks. *

Yes, I knowingly and freely assume all risks.

3. I understand that my participation is contingent on timely payment of all applicable fees and that I may be barred from participation if I am in arrears. *

Yes, I understand.

4. I, for myself and on behalf of my heirs and assigns, release, waive, discharge and covenant not to sue the Minnesota Synchronettes, its officers, agents, employees, volunteers and sponsors from any and all liability for any and all claims, demands, losses and damages on account of illness, injury, including death and damage to property, whether caused by negligence or otherwise. *

Yes, I agree on behalf of my heirs and assigns, release, waive, discharge and covenant not to sue the Minnesota Synchronettes, its officers, agents, employees, volunteers and sponsors from any and all liability for any and all claims, demands, losses and damages on account of illness, injury, including death and damage to property, whether caused by negligence or otherwise.

6. I will communicate to the coach if they become ill or experience covid symptoms during practice. *

Yes, I understand and I will communicate.

7. I will stay home if I am sick or experiencing symptoms or have been exposed to someone who tested positive for COVID-19. *

Yes, I understand and will stay home.

Participants Signature and Date

if 18 or over.

First Name

Last Name

Date

MM

DD

YYYY

Parent/Guardian Signature & Date *

First Name

Last Name

Date *

MM

DD

YYYY