Parent’s Name:             _____________________________________________________________
 
Address:                        _____________________________________________________________

                                      _____________________________________________________________
                                             
Phone Number              _____________________________________________________________
 
          
E-mail Address:          _____________________________________________________________

Swimmer’s Name(s)                                                Age              Date of Birth
                        
1. _______________________________    ____    ________________

2. _______________________________    ____    ________________

3. _______________________________    ____    ________________

4. _______________________________    ____    ________________

           I give permission for my child (ren) to participate in all swim team activities.
           I am a member of the Oakview Pool and membership dues for 2011 are paid.

Parent’s Signature: ________________________________   Date __________________
Swim Team Fees: Swimmers must be siblings.
    One swimmer         $95.00
    Two swimmers       $140.00
    Three Swimmers    $175.00
    Four swimmers      $200.00
    Family Cap            $235.00

Make checks payable to Oakview Recreation Corporation. Please mark checks for the Swim Team.

Payment must be included with Registration Form. Return form and payment to the Team Rep.
                Amount Enclosed: $_______________________

Office Use:     Amount Received: ___________         Received by: ___________(initials)
Check Number:      ___________         Date: __________________