High Lane Club
Swim and Dive Team Registration

Sunday, May 19, 2019

Child’s First and Last Name, Age, and Team choice: (Swim & Dive, Swim only, Dive only)
 
1._____________________________________________________________
 
2._____________________________________________________________
 
3._____________________________________________________________
 
Parent’s name(s):________________________________________________
 
Email:_______________________________ Phone:_____________________
 
Emergency Contact Name:_________________________________________
 
Emergency Contact Phone:_________________________________________
 
Swim Team Cost:

• 1^st child $135

Discounts for multiple children! Sign up the whole gang! We Love a family of swimmers!

• 2^nd child: $240 total or $120 per child
• 3^rd child $330 total or $110 per child

Dive Team Cost:

• $100 1st child
• $80 2nd child
• $60 3rd child

Amount Paid:__________ CK#__________ Charge HLC Account: Y /N

Yes,___ (please √) my child(ren)________________________ can be used in photography and video

for any legal use of publicity/advertising/web content.

No, ___ (please √) my child(ren) ____________________ is NOT permitted in photography and video

for any legal use of publicity/advertising/web content.

**Each parent will be required to be a Time keeper (during all meets). Schedule to follow.

Thank You!