REGULAR SEASON 2019-2020 COMPETITIVE REGISTRATION

REGISTRATION FORM — SEPTEMBER 2019 - MAY 2020 — COMPETITIVE

Program (for assistance, please refer to our Programs page or send an email to reg.atlantis.synchro@gmail.com):

PROVINCIAL stream 9-10

PROVINCIAL stream 11-12

PROVINCIAL stream 13-15

NATIONAL stream 13-15

JUNIOR

SENIOR

Masters

Athlete category:

RETURNING (Fill out only NEW and REQUIRED athlete info)

NEW (Fill out ALL athlete info)

Athlete info:

Name:

Date of birth (dd/mm/yy):

Age on December 31, 2020:

Synchro experience (most recent):

Swim level (most recent):

Swimmer address:

Parent/Guardian 1 name:

Parent/Guardian 1 email:

Parent/Guardian 1 phone:

Parent/Guardian 2 name:

Parent/Guardian 2 email:

Parent/Guardian 2 phone:

New swimmers: How did you hear about us?

Canada Artistic Swimming requires proof of date of birth for all registered swimmers in the form of a copy of the athlete's birth certificate. Please choose one of the following:

RETURNING swimmer, birth certificate copy on file

NEW swimmer, please email a copy of birth certificate along with signed consent forms below

Payment (once you submit online registration, you will receive a confirmation email with payment instructions):

Frequency:

MONTHLY PAYMENTS (Due on the 16th of each month from AUGUST through APRIL. Pre-Authorized Debit ONLY)

BI-ANNUAL PAYMENTS (Due on SEPTEMBER 1 and FEBRUARY 1 of the competition year. Pre-Authorized Debit, Email Money Transfer or Credit Card)

ANNUAL PAYMENT (Due on SEPTEMBER 1 of the competition year. Pre-Authorized Debit, Email Money Transfer or Credit Card)

Method:

Pre-Authorized Debit

Email Money Transfer — available for bi-annual and annual payments only

Credit Card —available for bi-annual and annual payments only. ASSC accepts credit card payment using PayPal invoice. The fee for this method of payment is 2.9% plus $0.30 per transaction.

I understand that registration is NOT complete and my swimmer CANNOT begin training without the following:

Online registration form received

Payment confirmed and first payment received

Completed and signed consent forms (linked below) emailed to reg.atlantis.synchro@gmail.com. PLEASE NOTE: these forms are required ANNUALLY for ALL swimmers, including RETURNING swimmers.