Registration Form

Swimmer Details

Name:

Home Address:

Joining Date:

Please advise preferred email addresses for club correspondence

Email Addresses:

Parent/Caregivers Details

Main Contact:

Alternate Contact:

Membership Details

Renewing Membership with Roskill Swimming Club

New Membership

Transferring Membership from

Please also log in to your SNZ 'My Page' and complete a transfer request.

Membership Category and Squad

Competitive Swimmer

Non-Competitive Swimmer

Platinum - 700+ Fina points in multiple events	Multi Sport squad (3 sessions)
Gold - 500+ Fina points in multiple events	Multi Sport squad (2 sessions)
Silver - 300+ Fina points in multiple events	Multi Sport squad (1 session)
Bronze - 100+ Fina points in multiple events
Senior Development
Development

Health Profile

Are there any medical conditions, major injuries, disabilities or allergies which could affect the swimmer’s ability to take part in the planned activities, or would be necessary for a Roskill Swimming Club Coach/Team Manager to know in order to exercise reasonable care? (Please advise details)

Yes

Is your child currently taking ongoing medication?

Yes

Are the swimmer’s tetanus injections up-to-date?

Yes

Is the swimmer fully immunised?

Yes

Is there any other information a Roskill Swimming Club Coach/Team Manager should know to ensure the physical and emotional safety of your child? (For example cultural practices; disability; anxiety; custodial issues; behaviour or emotional issues).

Yes

Permissions

I give permission for Panadol to be administered to my child for pain or fever as necessary.

Yes

In the event of an emergency I authorise the obtaining of any medical assistance deemed necessary and agree to meet any costs incurred.

Parents/caregivers of Competitive Swimmers please note: Swim meets are run by volunteers and all Swimming Clubs are required to help out to ensure meets runs efficiently and accurate records are kept. Parents/caregivers will be asked to help out with time keeping, managing swimmers or other tasks. These tasks are not difficult and training will be given at the time. Help from parents is essential and is greatly appreciated. We run a roster system and it is expected that all parents/caregivers help when requested. By entering your swimmer into swim meets you are committing to helping out when required.

Terms and Conditions:

1	Members are bound by Swimming New Zealand (SNZ), Auckland Swimming Association (ASA) and Roskill Swimming Club’s code of conduct.
2	Roskill is committed to providing a safe environment for everyone participating in swimming. Everyone is encouraged to play a vital and responsible role in maintaining a safe and healthy environment.
3	Competitive: The first payment for professional coaching fees must be made at the time of enrolment and thereafter by automatic payment on the 20th of each month, payable in advance to Roskill Swimming Club's bank account 06-0177-0108914-00.
4	Enrolment is for a minimum of 3 months from the start date. Competitive squad swimmers are billed for 12 months of the year payable in monthly instalments irrespective of attendance. Holiday training will be available at the Director of Coaching's discretion. If a swimmer is to be absent from training for more than 1 month application for dispensation of fees may be made to the committee in advance. Dispensation will be considered on a case by case basis.
5	Multi sport: The first payment of professional coaching fees must be made at the time of enrolment and thereafter by the end of the first week of the term, payable to Roskill Swimming Club's bank account 06-0177-0108914-00. Non-competitive squads are billed each term and no holiday training will be scheduled.
6	Payment for professional coaching does not include club registration; meet fees, camps, uniforms and other activities offered by Roskill Swimming Club.
7	Membership is not transferable or refundable. There are no make-up sessions.
8	Roskill Swimming Club reserves the right to make fee adjustments with one month’s notice to members.
9	Roskill Swimming Club reserves the right to move swimmers to a different squad or refuse/terminate membership if a swimmer does not conform to the Swimming New Zealand, Auckland Swimming or Roskill Swimming Club’s code of conduct.
10	Members with unpaid fees will be suspended. Suspension does not relieve the member/parent/guardian from their obligation to pay the outstanding amount. Members are required to terminate their membership in writing before the due date, giving one month’s notice, even if the swimmer has not been attending.
11	Roskill Swimming Club will forward unpaid debts to a debt collection agency. Fees incurred to recover a debt will be for account of the member/parent/guardian.
12	The personal information provided in your membership application is collected, used and disclosed in accordance with the SNZ Privacy policy SNZ Privacy policy .

These Terms and Conditions will supersede all previous contracts with Roskill Swimming Club or affiliated partners. Submitting this enrolment form constitutes acceptance of these Terms and Conditions.

Acceptance of Terms & Conditions

This must be completed by a Parent/Guardian if the swimmer is under 18 years.

I have read and understood this application form and the applicant’s membership declaration.

I consent to the application for membership on this basis and the use of my personal information as disclosed above.

I agree to allow photograph, video, multimedia or film likeness taken by Roskill Swimming Club approved photographers to be used for any legitimate purpose by Roskill Swimming Club.

Submitted by

Sponsors