Online Registration Form

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