Mayde Creek Aquatic Club
Registration Form for 2011/2012 Season
Last Name
First Name
MI
DOB
(Date of Birth)
Age
         
         
         
         
Swimmer Information
Street Name and Address:

___________________________________________________________________

City/Zip:_____________________________

*** E-Mail Address:__________________________________________________PLEASE INCLUDE

Parent/Guardian#1 Info.  
                                              Parent/Guardian #2 Info.
Name:____________________________                    Name:_______________________________
Work#:___________________________                     Work#:______________________________
Cell#:____________________________                     Cell#:________________________________  

Please indicate which number can receive a text or message for club info.
Program
Reg Fee
Tuition for
April 2012
# of
Swimmers
Sub-Total
Discount
$10 on 2nd
$15 on 3 or more
TOTAL
Group 2
$50
$75
       
Group 2.5
$50
$75
       
Group 3
$50
$85
       
Group 4
$50
$95
       
HSR
$50
$100
       
             
Group Info:
Group 2 swims 4:30 to 5:30 or 5:30 to 6:30.  Swimmer needs to have a basic knowledge of free and back.  Comfortable
swimming an hour workout unassisted.

Group 2.5 swims 4:30 to 5:30 or 5:30 to 6:30.  Swimmer displays knowledge of free and back and is ready to progress to
breast and fly.

Group 3 swims 4:30 to 5:30 or 5:30 to 6:30.  Swimmer is legal in all four strokes.  Still needs perfecting stroke skills
and building on technique.

Group 4 swims 6:30 to 8:00 pm.  Swimmer demonstrates fluidity on all strokes.  Has strong skills, but needs to refine
other aspects of swimming.  Some of these swimmers may be young and at times may only need to swim one hour.  

HSR (High School Readiness) swims 6:30 to 8:00 pm.  Swimmer needs to be in at least sixth grade.  They have the
desire to swim in high school.  Will work on technique and all aspects of preparing for the high school events.
Medical Information:
Any known allergies or other information of which we need to be made aware:_________________
______________________________________________________________________________
Doctor's name and phone number:__________________________________________________

Swim Information:
Summer Swim Team:_________________________________________________________

_____I understand that MCAC is NOT a month-by-month program, but rather an 8 month season for which I am enrolling
my swimmer.  If my swimmer decides to take any time off I am still responsible for the monthly fee.  If I do not make the
payments, and wish to continue swimming at a later time, I will be required to pay the registration fee again.

_____I understand that if I decide to withdraw from the program the last month's prepaid tuition and registration fee are
NON-REFUNDABLE.

_____I understand that all monthly training fees are due by the first of each month.  I understand that there is a $10 late fee
for payments received after the 10th of each month.


Parent/Guardian Signature__________________________________________Date______________________
Please Print out the forms and mail them with payment to the following:

Mayde Creek Aquatic Club
3635 Windlewood Dr.
Katy, TX 77449
Mayde Creek Aquatic Club