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2024 Rama Swim Team Contact & Medical Consent


2024 Swim Team Parental Contact and Medical Release Form


Contact Info






Additional contact info

Please provide any other important contact info.

Number of children you are enrolling


Will you be participating in the House Team or League Team?


Child 1 First Name


Child 1 Last Name


Child 1 Age

Please enter the birthday and age the child will be by June 1, 2024.



Child 1 T-shirt size

Enter their size

Child 1 Gender


Child 1 allergies or other needs

List any important information we should know

Additional Questions


Emergency Contact name (not already listed)

Write in your answer below...

Emergency Contact phone

Write in your answer below...

Child's Primary Care Physician name

Write in your answer below...

Child's Primary Care Physician phone

Write in your answer below...

Child's Dentist name

Write in your answer below...

Child's Dentist phone

Write in your answer below...

MULTIPLE CHILDREN REGISTERING: If you need to identify different doctors and dentists for your children, please use this space. Identify the child and their doctor and/or dentist.

Write in your answer below...

Health Insurance Carrier

Write in your answer below...

Insurance Group #

Write in your answer below...

Hospital preference:


PARENT/GUARDIAN AGREEMENT: As a Parent/Guardian of a Rama Swimmer, I agree that I will participate in the meets by signing up to assist in a minimum of two (2) meets each season.


MEDICAL DISCLAIMER:

I understand that Rama Swim Club, Inc. assumes no responsibility for injuries or illness which my child may sustain as a result of his/her condition or resulting from his/her participation in any swim team activities. I expressly acknowledge that I assume the risk for any and all injuries that may result from his/her participation in these activities. I hereby voluntarily release, indemnify, hold harmless and discharge Rama Swim Club, Inc. and its officers, directors, agents, and employees from all claims for injury, death, loss, or damage which my child may suffer as a result of his/her participation in these activities. I hereby give permission to the medical personnel identified above or selected by Rama Swim Club, Inc. to order x-rays, tests, treatment, and to release any records necessary for insurance purposes and to provide or arrange any necessary related transportation for me or my child. In the event that I cannot be reached for an emergency, I hereby give the physician listed above or selected by club personnel, to secure and administer treatment, including hospitalization, for my child. I understand that no accident or medical insurance is provided with these activities.

ELIGIBILITY RULES:

It is required by Rama Swim & Racquet Club that all family members participating on the swim team must pay their dues prior by April 30, 2024 to be eligible to swim on the team. Please contact Club President if you have any questions about your balance. Per the QCSL Eligibility Rules: To be eligible for the current season, swimmers must be 18 years or younger on the May 31 that falls during, or immediately prior to the start of, the current season.

SWIMMER BEHAVIOR/SPORTSMANSHIP GUIDELINES: All swimmers are held to high standards of behavior and sportsmanship at all times. We will be respectful of ALL coaches and adult volunteer requests at all times. We will build up our teammates. At meets, we will remain in the pool until all swimmers in their event are done, and congratulate nearby swimmers when they finish. At meets, we will clean up after ourselves. At meets, we will arrive at the ready-benches on-time, knowing that if we can't be f


PARENT/GUARDIAN/SPECTATOR GUIDELINES:

Per QCSL regulations, no alcohol consumption is allowed during swim league sanctioned times (during meets and practice). The Rama Pirates Swim Team also asks that you monitor your swimmer's whereabouts during meets to ensure they get to their event early for lineup. Finally, be advised that the Pirates' Cove and Baby Pool areas are closed during meets due to liability and safety concerns.

Submissions closed as of Saturday, Jun 01, 2024