Zeeland Recreation 320 E Main, Zeeland MI 49464 Ph: 616-748-3230 Fax: 616-748-3234

West Michigan Swimmers Bronze-10&Under 2015 Summer Registration Form Swimmer’s Name ________________________ Birth Date _____/_____/_____ M.I._______ Parent/Guardian(s) __________________________________________________________ Address___________________________________________________________________ City__________________________________ Zip_________________________________ Home Phone __________________________ Cell ________________________________ E-mail ____________________________________________________________________

Description

Fee

Amt Paid

WMS Administrative Fee Includes USA Athlete Registration (valid thru Dec 31, 2015)

$95

(Only needed if not currently USA Registered) First time USA swimmers, contact Coach Cody Tozer at 616-748-4752 or [email protected] for further information.

Coaching Fee (Long Course Season) Due Before your athlete(s) start practice R=Zeeland Resident

$220-R $232-NR

NR=Non Resident

Total

Parent meeting will be at Zeeland West High School on Monday, April 13 at 6:30pm. Additional information is available at www.zeelandswimming.org Please return completed form and payment to Zeeland Recreation. Checks made payable to: Zeeland Recreation MC _____ Visa _____ Discover _____

Amount Paid _______________

Card # ___________-___________-____________-___________ Exp Date ______/______ Signature __________________________________________________________________