*UCSC*

*Application for Membership*

*Indoor Season * *2005-2006* 

* Father’s/Guardian’s First and Last Name*

*  *

 

	

* Mother’s/Guardian’s First and Last Name*

*Home Address*

	

*Home Address*

*  *

 

*City                                 State              Zip*

	

*City                                 State              Zip*

 

*Home Phone *

	

*Home Phone*

 

*Business Phone*

	

*Business Phone*

 

*Cellular/Pager*

	

*Cellular/Pager*

 

*E-mail Address*

	

*E-mail Address*

 

 *Swimmer(s) Enrolling* 

*Child’s Name*

	

*Age*

	

*Gender*

	

*Birthdate*

	

*School*

	

*Group*

 

	

 

	

 

	

 

	

 

	

 

 

	

 

	

 

	

 

	

 

	

 

 

	

 

	

 

	

 

	

 

	

 

 

	

 

	

 

	

 

	

 

	

 

 


    Registration Fees Indoor Season 2005-2006

*Team*

	

*Training Fee* *per Month*

	

*USA Dues (mandatory)*

 

	

 

	

 

SuperSwimmer

	

$40

	

$46

AGD

	

$50

	

$46

Senior

	

$50

	

$46

High School Prep (HSP)

	

$50

	

$46

Masters

	

$40

	

Swimmer’s responsibility

*  *

*Please read the following information thoroughly and initial below. *

   1. *Training fees will be divided into quarterly installments*
   2. *100% of USA Swimming dues are due at registration*
   3. *Meet fees will be billed later in the season*
   4. *After the first four weeks of the winter session, fees are _not
      refundable_. In the event your child stops swimming for UCSC,
      please notify the Treasurer or another Board member immediately.*