TIDALWAVES 2010 REGISTRATION

Registration Steps:
(1) Fill out information below (including health insurance provider, doctor, emergency contacts etc.) SUBMIT at bottom of page
(2) Fill out and, print, and sign Liability Release and Waiver Form
(3) Fill out and print Payment Form, attach check (payable to City of Larkspur) or provide credit card information

Rates: $395 (first swimmer), $360 (each additional swimmer), $100 (high-school swimmer)

(4) Mail both the Liability Release/Waiver Form, and the Payment Form to:
Larkspur Recreation Department
240 Doherty Dr.
Larkspur, CA 94939-1532

(5) Return to sign-up for volunteer points or choose "buy-out" option ($500)

* Required Information

Swimmer Information

Name - Swimmer #1 * first last	Birthdate * month day year	Gender * male female	Tidalwaves Swim Experience * new returning	High School Swim Team *
Name - Swimmer #2 first last	Birthdate month day year	Gender male female	Tidalwaves Swim Experience new returning	High School Swim Team
Name - Swimmer #3 first last	Birthdate month day year	Gender male female	Tidalwaves Swim Experience new returning	High School Swim Team

Parent Information

	Parent Name * first last	email address *	Phone Numbers * home cell or work	Home Address * street city zip code
	Parent #2 Name first last	email address	Phone Numbers home cell or work	Home Address (if different from above) street city zip code

Medical Information

	Health Insurance Company *
	Doctor's Name	Doctor Phone
	Dentist's Name	Dentist Phone
	Please list medical conditions or allergies for swimmer #1 Please list medical conditions or allergies for swimmer #2 Please list medical conditions or allergies for swimmer #3

Emergency Contacts

Emergency Contact * (other than parents)
full name

Emergency Contact * (other than parents)
phone

Emergency Contact #2 (other than parents)
full name

Emergency Contact #2 (other than parents)
phone

Service Commitment

	Volunteer Service Commitment * As with other teams in the Marin Swim League, Tidalwaves depends on the active support of the swimmer’s parents during the season. At least one parent in each swimmer’s family is asked to work at swim meets in which the child participates, or assist with other team-related activities. Training will be provided for all jobs. All volunteers need to check in at the Check In Desk at each swim meet. I agree to fulfill my service commitment. Each family will be required to complete at least 20 points worth of volunteer service (~20 hours) during the course of the 2010 Tidalwaves season. Jobs must be chosen on-line before February 1, 2010. Each job assigned to a family but not completed will be assessed a $30 per point fine. It is the responsibility of your family to know your assignments and to arrange a replacement if necessary. For this purpose, all jobs and volunteer contact information will be posted on-line. If you prefer, your service commitment will be waived upon receipt of your “buy-out” payment in the amount of $500. I Agree Buy-out ($500)
	Waiver & Release / Consent for Medical Treatment
	Waiver & Release / Consent for Medical Treatment * Download, Read, and Sign Liability Release Agreement and Waiver mail to: Larkspur Rec. Dept., 240 Doherty Dr., Larkspur, CA 94939-1532 I Agree with Waiver & Release Terms
	Payment Invoice Download and Complete Payment Form mail to: Larkspur Rec. Dept., 240 Doherty Dr., Larkspur, CA 94939-1532
	(or save electronically)