N R S T

Based at the Nanaimo Aquatic Centre

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How to Register

Wednesday, 03 September 2008 19:01 Mike Gossland

Nanaimo Riptides Registration
Nanaimo's year-round competitive and developmental swim team.

Name

First

Last

Date of birth

Address

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Home Phone Number

###

####

Work Phone Number

###

####

Cell Phone Number

###

####

Email

Emergency Contact Name

Emergency Contact Phone Number

###

####

Doctors Name

Doctors Phone

###

####

Medical Number

Known Allergies or Medical Conditions

Stage / Group

View Group selection chart here. View Riptide training times here.

Requested Class Times

*Only 'I Can Swim' to Blue groups fill out this section.

Monday 4:00p.m.

Monday 5:00p.m.

Tuesday 4:00p.m.

Tuesday 5:00p.m.

Wednesday 4:00p.m.

Wednesday 5:00p.m.

Thursday 4:00p.m.

Thursday 5:00p.m.

Friday 4:00p.m.

Friday 5:00p.m.

SWIM B.C REGISTRATION / INSURANCE (ANNUAL FEE)

MONTHLY OR SESSION FEE

View group registration fees here.

TOTAL TO TREASURER (MAKE PAYABLE TO N.R.S.T.)

Payment Method

Cash

Cheque

Post Dated Cheques

*Please note that your registration is not complete until our office staff recieve your first payment.

**POST DATED CHEQUES ARE REQUIRED FOR MONTHLY
SWIMMERS.
*** PARENT(S) NOTICE OF 30 DAYS FOR
MONTHLY SWIMMERS MUST BE GIVEN PRIOR TO REMOVING
YOUR CHILD FROM SWIMMING. CHECK OUT OUR WEBSITE
FOR ALL INFORMATION IN OUR N.R.S.T HANDBOOK.
SESSIONAL SWIMMERS REQUIRE ONE (1) WEEK NOTICE.

Mothers Name

Fathers Name

Checkboxes*

I agree that I am the legal parent or gardian of the above listed participant. I agree to the terms and conditions listed in the payment method section of this registration form.