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| Mayde Creek Aquatic Club Registration Form |
Athlete Contact Info.
Athlete - Last Name________________________ First Name______________________ MI_______
Preferred Name____________________
Preferred Name____________________
Parent/Guardian #1 Info. Parent/Guardian #2 Info.
Fees and Rates:
There is a yearly $50 registration fee per child.
Swim-Up Program $55
M/F ____4:30 - 5:00 ____ 5:00 - 5:30 ____5:30 - 6:00 ____6:00 - 6:30 ____6:30 - 7:00
T/TH ____4:30 - 5:00 ____ 5:00 - 5:30 (w/Coach Larry) ____5:30 - 6:00 ____6:00 - 6:30 (w/Coach Mary)
Please indicate which session you request. We will let you know if the session is full and which ones are open.
M/F ____4:30 - 5:00 ____ 5:00 - 5:30 ____5:30 - 6:00 ____6:00 - 6:30 ____6:30 - 7:00
T/TH ____4:30 - 5:00 ____ 5:00 - 5:30 (w/Coach Larry) ____5:30 - 6:00 ____6:00 - 6:30 (w/Coach Mary)
Please indicate which session you request. We will let you know if the session is full and which ones are open.
*** Please Print Form and either register in person at Mayde Creek High School
or mail completed form to :
or mail completed form to :
Mayde Creek Aquatic Club
Coach Jim Thompson
3635 Windlewood Dr.
Katy, TX 77449
Email Coach Jim
Coach Jim Thompson
3635 Windlewood Dr.
Katy, TX 77449
Email Coach Jim
____ 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 at that time.
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 at that time.
Birth date:____________ Current Age: ________ Sex:_______M ________F
Street Name and Address:_________________________________________________
City/State/Zip: _________________________________________________
City/State/Zip: _________________________________________________
Email Address: _________________________________________________________PLEASE INCLUDE EMAIL_
Name:______________________ Name:__________________________
Day#: ______________________ Day#: __________________________
Eve#: ______________________ Eve#:___________________________
Medical Information:
Any known allergies or other information of which we need to be made aware. _____________________
________________________________________________________________________________
Doctor's name and number:_________________________________________________________
Any known allergies or other information of which we need to be made aware. _____________________
________________________________________________________________________________
Doctor's name and number:_________________________________________________________
___8 days per month = $60 ____12 days per month = $70 ___Unlimited workouts = $80
$50+$60=$110 sign up $50+$70=$120sign up $50+$80=$130 sign up
$50+$60=$110 sign up $50+$70=$120sign up $50+$80=$130 sign up
_____I understand that all monthly fees are due by the first of each month,
September thru April, unless prepaid for the season.
____ I understand that there is a $10 late fee for payments received after the
10th of each month.
Parent/Guardian Signature___________________________Date___________
September thru April, unless prepaid for the season.
____ I understand that there is a $10 late fee for payments received after the
10th of each month.
Parent/Guardian Signature___________________________Date___________