Registration begins April 1st! Sign Up before May 1 st and receive $25 off!

1. WEST West Coast Family Aquatic Center COAST AQUATICS SUMMER SWIM TEAM 2012 June 25th-August 17th. A summer competitive swim team for swimmers ages 5 to 18, interested in getting a taste of competitive swimming in a fun, safe and non-threatening environment. Registration begins April 1st! Sign Up before May 1st and receive $25 off! • Swimming: • is a lifelong, non-contact, low injury sport. • is the most popular form of physical exercise in the United States today. • offers kids the opportunity to participate in competition regardless of ability. • Experience Competition: • short dual meets along with a season ending Summer League Championship allow swimmers to show their stuff on a regular basis. • every swimmer who swims his or her best is a winner at WEST! • Working together for the good of the team is our key to success at West Coast Aquatics. • You will: • learn the skills needed to be successful in competitive swimming. • do stroke drills and games that make learning fun, while developing good stroke technique and making friends. • build your self-confidence and self-esteem through swimming. • be the best you can be by measuring one stroke at a time. • West Coast Aquatics: • Offers one of the finest age group swimming programs and the best coaching in the Snohomish & Northern King County area. • founded in 1990, WEST has won numerous honors and championships. • through the years individual swimmers have advanced to represent WEST at State, Regional and US National Championships. The Best Deal in Town: The cost for the nine-week program, June 25th – August 17th, is just $225 (registration includes WEST team t-shirt, swim cap & name tag) Practices are Monday through Thursday Afternoon Session 11:30 am – 12:30 pm@ WEST Night Session 6:30 pm – 7:30 pm @ WEST For more information call: West Coast Aquatics @ 425.379.8806 westcoastaquatics.us Registration is in person at West Coast Aquatics.

2. WEST Summer Swim Team 2012 Registration Form SWIMMER’S: Last: First: Middle: Birth date: Age: Sex: M F Phone Number: PARENT: Name: Relationship: Phone: Name: Relationship: Phone: Address: City: Zip Code: E-Mail: Emergency Phone: I hereby release West Coast Aquatics and the West Coast Family Aquatic Center, it’s officers, coach’s, and/or representatives from any liability which may arise out of my child’s participation in any of said program’s activities, games, practices, or transportation to or from such events, and to hold said team and club, it’s officers, coaches, and/or representatives harmless from any expense or claim for damages which may be incurred on behalf of such child for any injury, illness, or accident which may occur in connection with such child’s participation herein. Signed (legal parent or guardian): Date: SELECT SESSION: West Aquatic Center 11:30 – 12:30 PM 6:30 – 7:30 PM TEAM T-SHIRT: Circle appropriate size (cost included in registration) Youth: Med (10-12) Large (14-16) X-Large (18) Adult: Small Medium Large X-Large PAYMENT: Total Due with registration is $225 ($200 if you register before May 1st!) Mail completed registration with payment or bring to: West Coast Aquatics 15622 Country Club Drive Mill Creek, WA 98012 We accept: cash, check, VISA or MasterCard payments Make checks payable to West Coast Aquatics Available space on the team is filled on a first come, first serve basis. MEDICAL INFORMATION: Is your child currently taking any medications? Please list: Any known allergies?: Does your child have any specific health problems, for which staff should be aware? (vision or hearing loss, seizures, allergies, etc.) If yes, please explain: Physicians Name: Phone: Medical insurance coverage by: Policy Number: Membership Number: CONSENT FOR MEDICAL CARE AND TREATMENT OF A MINOR: I, ___________________________, the natural parent/guardian of minor childe _______________________, authorize and give consent to medical, surgical, and hospital care, treatment and procedures to be performed for my child by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health and I cannot be contacted. I waive my right of informed consent to such treatment. Signed (legal parent or guardian): Date: