Swim and Dive Team Application(Please Print Legibly)
Bond Holder's Name __________________________________________
Address _____________________________________________________
Home Phone ___________________ Work Phone ___________________
Emergency Contact __________________ Phone ____________________
|
FEES
Swim Team - $75 for first child, $65 each additional child
- must include signed Tri-County liability waiver and volunteer form
Dive Team - $75 per child - this is not an increase; it includes the diving association fee and insurance, which will be paid by the club. SJ Diving is no longer accepting personal checks.
|
Child's Name
Birth Date
|
Swim/Dive
|
Total Due
|
|
_____________ ___/___/____
|
$75 / $75
|
________
|
|
_____________ ___/___/____
|
$65 / $75
|
________
|
|
_____________ ___/___/____
|
$65 / $75
|
________
|
|
_____________ ___/___/____
|
$65 / $75
|
________
|
|
_____________ ___/___/____
|
$65 / $75
|
________
|
|
Total due:
|
________
|
All must sign a waiver, swimmers must complete a volunteer form.
Please make check payable to
"Covered Bridge Swim Club, Inc."
mail check and this form to:
Covered Bridge Swim Club
P.O. Box 1203
Cherry Hill, NJ 08034
|
|