2019-2020 Registration

Swimmer Information

Swimmer*

First

Last

Nickname:

Address:*

Street AddressCityState / Province / RegionPostal / Zip Code

Gender:

Female

Male

Date of Birth:

day

month

year

Upload Swimmer Photo (Headshot) for the team roster (.jpg or .gif file format):

Grade:

School:

Experience:

Other Experience:

Size Chart

Swim Suit Size:

If your swimmer does not have a telephone number or e-mail address, then please leave these fields blank.

Phone (Optional):

Area Code

Phone Number

Phone Type:

E-mail (Optional):

Guardian & Emergency Contact Information

Guardian (G1):*

First

Last

Relationship (G1):*

Upload Guardian (G1) Photo (Headshot) for the team roster:

Address (G1):*

Street AddressCityState / Province / RegionPostal / Zip Code

E-mail (G1):*

Primary Phone (G1):*

Area Code

Phone Number

Phone Type (G1):*

Phone (G1A):

Area Code

Phone Number

Phone Type (G1A):

Only one guardian is required; however this information will be used in case of emergency. If there are two parents/guardians, then please list both.

Guardian (2):

First

Last

Relationship (G2):

Upload Guardian (G2) Photo (Headshot) for the team roster:

Address (G2):

Street AddressCityState / Province / RegionPostal / Zip Code

E-mail (G2):

Primary Phone (G2):

Area Code

Phone Number

Phone Type (G2):

Phone (G2A):

Area Code

Phone Number

Phone Type (G2A):

Parents/Guardians will be contact first in case of emergency. This individual will be called, if we're unable to reach you.

Emergency Contact:*

First

Last

Relationship (EC):*

Primary Phone (E1):*

Area Code

Phone Number

Phone Type (E1):

Phone (E2):

Area Code

Phone Number

Phone Type (E2):

1/3

Photography & Media Release

The undersigned authorizes NVS Synchro to permit photographers/videographers employed or designated by NVS Synchro to take photographs and/or film/video footage of and to obtain quotations and information from the undersigned.

Such photographs, film/video footage and recorded comments may be used for educational purposes, publications and/or broadcasts which may include but not limited to the following: newspapers, radio, television, staff newsletters, photographic displays, and publicly distributed publications such as annual reports, external newsletters, news releases, pamphlets, brochures, websites, flyers and promotional publications and the undersigned shall be entitled to no compensation as a result of such use from NVS Synchro.

May the swimmer's photograph be used in social media, online and in press releases to promote NVS? *

Yes

2/3

Scroll to Select Level & Payment Option:*

Club Dues

The season runs from September through June.

New swimmers receive a discounted rate of $75 during the month of September, while the swimmer and their family try synchro. At the end of the trial period, the swimmer will be assigned a level and the family will indicate, if they wish to continue.
Returning swimmers should sign-up for the previous season's level or as instructed by their coach. The coaches will make final placements in the beginning of October. If your swimmer moves up a level, then billing will be adjusted.
There are two payment options:
A) In installments over the first 5 months of the season.
B) In full at the beginning of the season with a five percent discount.
At check-out, if you're paying via check, then disregard the 3% PayPal fee (tax).

If you have chosen to pay by check , please submit check payments to:
NoVa Synchro, Inc.
P.O. Box 5712
Arlington, VA 22205
If you opt to pay via PayPal, please send payments to nvstreasurer@gmail.com.
Thank you in advance for your dues payment.

Payment Method:

Check

PayPal

Verification:

3/3