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Swimmer Registration
Please select what Program you would like to register your child for
*
Fundamentals Pre-Competitive
Fundamentals Competitive
Competitive Skills
Competitive Development/Competitive Open
Swimmer
First name
*
Second name
*
Date of Birth
*
(DD/MM/YYYY)
Gender
*
Male
Female
Phone
*
Email
*
Swimmer Contact Info
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Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
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Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombi
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepa
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Medical Information
Please select 'yes' if the swimmer has any health concerns (i.e. ADHD, outbursts, allergies, or any others requiring extra attention).
Medical concerns
*
Yes
No
Please describe
Emergency Contact
*
(Name, Relationship)
Phone
*
Waiver Agreements
Please review each document carefully.
Please read each waiver carefully. It is mandatory to agree to all items before continuing with registration.
*
I agree to the KWST Code of Conduct
I have read and agree to the Swim Ontario PIPEDA consent form
I have read and agree to the KWST Hand Book
Photography / Video Waiver
*
Select the appropriate response for the "Photo/video Release Form" waiver
Yes
No
Parent/Guardians
Parent / Guardian
*
Father / Stepfather / Guardian name
Parent / Guardian Phone
*
Second Parent / Guardian
Mother / Stepmother / Guardian
Phone of Mother / Stepmother / Guardian
Additional Pickup Information
Please indicate permissions for pickup.
Person permitted to pick up your child from practice
Name / Relationship
Person NOT permitted to pick up your child from practice
Name / Relationship
Text
Date
HTML
Verification
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Example: 12
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