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TROJAN AQUATIC CLUB
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Registration for Winter 2022/2023
*
Indicates required field
Parents Name:
*
Parents Name 2
*
Address
*
Emergency Contact Number
*
Parents Cell
*
Parents Cell (2)
*
Parents Email
*
Parents Email (2)
*
Dates Swimmer is NOT Available
*
Swimmer's Name
*
First
Last
Gender
*
Male
Female
Swimmer's DOB
*
Age as of 12/1/22
*
Swimmer's Name
*
First
Last
Gender
*
Male
Female
Swimmer's DOB
*
Age as of 12/1/22
*
Swimmer's Name
*
First
Last
Gender
*
Male
Female
Swimmer's DOB
*
Age as of 12/1/22
*
Medical Release Information:
Primary Medical Insurance Name:
*
Policy Number:
*
Preferred Hospital:
*
Known Allergies or Other Pertinent Medical Information:
*
Would you be interested in placing a TAC yard sign on your property?
*
Yes
No
Swimmers will be in the pool beginning October 17, 2022. Practice schedules will be provided after registration is complete.
Registration Fee is $260 per swimmer. Additional swimmers in the same family each receive a $20 discount.
Fees may be paid by check or Venmo @tacswimming
Checks shall be payable to "TROJAN AQUATIC CLUB" and mailed to:
Trojan Aquatic Club
C/O R. Scarpato
1109 Smallbrook Lane
York, PA 17403
By submitting this form, I give my permission for my child to participate in the Trojan Aquatic Club. I will not hold the aquatic club, York Suburban School District or the coaching staff responsible for any injury while participating in the program. I also give permission for my child to be treated by emergency personnel in the event of an injury if I am not present.
Submit Registration
Participation and Consent Forms