East Liverpool Area YMCA Competitive Swim Team 

REGISTRATION FORM 

INSTRUCTIONS: Please complete the entire form and return the form with all of your 

participant’s registration materials. 

PLEASE PRINT ALL INFORMATION TODAY’S DATE: ______________ 

Participant’s Name _________________ Sex M F DOB ___/___/___ Age ___________ 

(As of October 1, 2008) 

Sizes: T-Shirt _______ Warm-Up ________ Swimsuit ________ 

Home Address________________________ City __________________ Zip ______________ 

Home Phone #__________________________ E-Mail Address ______________________ 

Parent/Guardian’s Name __________________________ Work Phone ___________________ 

Cell Phone ____________________ 

Emergency Contact Name _________________________ Phone ________________________ 

(Other than parent) 

Cell Phone ____________________ 

Special Medical Information ______________________________________________________ 

______________________________________________________________________________ 

AGREEMENT / WAIVER 

1. I herby certify that my child is in normal health and capable of safe participation in the YMCA Competitive Swim Team Program. I assume all risks and hazards incidental to the conduct of this program. I hereby authorize the YMCA to obtain medical treatment for my child in the event that I, nor my emergency contact cannot be reached. 

1. I support the YMCA Competitive Swim Team philosophy, which is based on: participation, fun, physical fitness, health, skill development, team work, fair play, family involvement, and volunteer leadership. 

1. I have received and reviewed the parent handbook for the Youth Swim team. 

_________________________________________ ________________ 

Signature of Parent/Guardian Date of Registration 

East Liverpool Area YMCA Competitive Swim Team 

PERSONAL GOAL SHEET 

INSTRUCTIONS: Please complete and return to the coaches. 

Please print all information (your parents may help you!) 

Name _________________________ Birthdate ___/___/___ Age ___________ 

List three of your hobbies: __________________________________________________________________ 

__________________________________________________________________ 

__________________________________________________________________ 

What goals do you wish to achieve as a member of the YMCA Competitive Swim Team? 

(for example: swim in dual meets, swim in AMS events) 

__________________________________________________________________ 

__________________________________________________________________ 

How can the coaches help you achieve your goals? __________________________________________________________________ 

__________________________________________________________________ 

List your best strokes and your best times in those strokes: (Please see examples below) 

50 Free :23.00 100 Free :54.00 200 IM 2:00.00 

1.___________________ 2. ____________________ 3. _________________ 

Have you ever been on a relay? Yes No 

Which relay? (Please Circle) 200 Free 400 Free 200 Medley 

What did you like best about the relays? 

__________________________________________________________________ 

Please return to Coach Maria. 

East Liverpool Area YMCA Competitive Swim Team 

ATHLETIC CODE OF CONDUCT 

INSTRUCTIONS: Please read the entire YMCA Competitive Swim Team Athletic Code of Conduct, and complete the requested information on the lower portion of this form. Please return the lower portion of this form with your participant’s registration materials. 

The undersigned participant agrees to abide by the standards of conduct outlined below in addition to those established by coaches. Any additional standards regarding conduct will be addressed by the Aquatic Director and coaches, whose combined responsibilities will be to inform the team and the parents. 

1. The possession or use of alcohol, tobacco, or any non-prescribed drugs is strictly prohibited. 

1. Athletes are expected to follow the directions of the coaching staff. 

1. Athletes will refrain from all illegal or inappropriate behavior that would detract from a positive image of the team or be detrimental to the team’s performance objectives. 

1. Athletes will display proper respect and sportsmanship towards coaches, officials, administrators, fellow competitors, and the community at large. 

1. Failure to comply with the Athletic Code of Conduct may result in, but not necessarily be limited to, any or all of the following actions: 

A. Athlete not allowed to participate in some or all team activities, parent notification. 

B. Athlete sent home, parent notification. 

C. Upon notification of any violation of the standards, the coaching staff and the Aquatic Director shall further review the situation, promptly determine what disciplinary action, if any, shall be taken. 

--------------------------------------------------------------------------------------------------------------------- 

(Detach and return with registration materials) 

COMPETITIVIE SWIM TEAM ATHLETIC CODE OF CONDUCT 

Athlete’s Name ___________________________________ Age ____________________ 

Parent’s Signature _________________________________ Date ___________________ 

Coach’s Signature _________________________________ Date ___________________