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2023/24 Registration

Home 2023/24 Registration

OUR FULL SEASON MEMBERSHIP FEES
$80 per swimmer – swimming 25m and above
$60 per swimmer – swimming 15m only
$50 per WASA swimmer- swimming mainly WASA events only
$20 for 1 non swimming parent
(only applies to families where an adult isn’t registered as a swimmer)

Registration 2023/24

Step 1 of 3

33%

Membership*
- Renewal
- New Member
- Transfer from other club
Previous Club Name
Parent/Adult Membership*
Parent 1 Name
First Last
Parent 1 Email
Date of Birth*

Day
Month
Year
Address*
Street Address Suburb State Postcode Country
Contact Number
Mobile Number
Merchandise
Branded Manly LAASC T-shirt/ swimming cap
T-shirt Size
Parent 2 Name
First Last
Parent 2 Email
Parent 2 Date of Birth

Day
Month
Year
Parent 2 Phone

How Many Children Registering*
- 0
- 1
- 2
- 3
- 4
Child 1 Membership
Merchandise
Branded Manly LAASC T-shirt/ swimming cap
T-shirt Size
Child 1 Name
First Last
Child 1 Date of Birth

Day
Month
Year
Child 1 Gender
- Male
- Female
Child 1 Age at 1st October 2023
Child 2 Membership
Merchandise
Branded Manly LAASC T-shirt/ swimming cap
T-shirt Size
Child 2 Name
First Last
Child 2 Date of Birth

Day
Month
Year
Child 2 Gender
- Male
- Female
Child 2 Age at 1st October 2023
Child 3 Membership
Merchandise
Branded Manly LAASC T-shirt/ swimming cap
T-shirt Size
Child 3 Name
First Last
Child 3 Date of Birth

Day
Month
Year
Child 3 Gender
- Male
- Female
Child 3 Age at 1st October 2023
Child 4 Membership
Merchandise
Branded Manly LAASC T-shirt/ swimming cap
T-shirt Size
Child 4 Name
First Last
Child 4 Date of Birth

Day
Month
Year
Child 4 Gender
- Male
- Female
Child 4 Age at 1st October 2023
Sub Total
$ 0.00

Available to Help with*
- time keeping
- runner
- 15m lane rope
- starter
- marshalling
- check starter
- website management
- times entry
- handicapping
Please list any health or medical conditions, disability or allergy concerns for each member.

Please also note the existing conditions are not covered under our accident insurance policy.
List Member Medical or Health Conditions
Emergency Contact Name
First Last
Relationship to Members
Emergency Contact Phone Number
1.   I agree to abide by the rules, regulations of MLAASC and Warringah ASA Inc.

2.   I authorise MLAASC and Warringah ASA to use or disclose to related and relevant bodies of my personal information that may be necessary to implement the rules, regulations and policies in 1 above.

3.   I Agree to have our names, photograph and results published in programs, newsletters and website.

4.   I authorise MLAASC and Warringah ASA Inc to use or disclose, to related and relevant bodies any of my child’s /Children’s personal information that may be necessary to implement the rules, regulations and policies in 1 above.
Declaration Name
First Last
Declaration Date

Day
Month
Year
Total
$ 0.00
Untitled
- First Choice
- Second Choice
- Third Choice
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