2017 Swimmer Registration Form
Parent’s Names
Address
City, State, Zip
Home Phone (
)
Emergency Contact Name
Parent Email address:
1.
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2.
Cell (
)
Phone (
)
Training Group Monthly Fee:
Pre Team
Bronze Group
Silver Development Group
Pre Silver Group
Silver JO Group
Sec Development Group
Junior National Group
Swimmer’s Name
Last, First Name
$140 / month
$170 / month
$190 / month
$190 / month
$205 / month
$215/ month
$250 / month
Date of Birth
Group Age
Sex
Monthly Fee
$
$
3.
2017 USA MEMBERSHIP FEE (required for all swimmers)
# Kids
X $64.00 each = $
4.
Annual Membership Fee $100 per member ($50 per additional sibling)
# Kids
$
TOTAL FEE
$
*Monthly fees due on the 1st of each month.
*Royal Swim Team Membership Fee due September 1st.
Payment method: Electronic Credit Card or ACH Bank processing through “Teamunify”.
Contact information:
Head Coach Val Bagri
Phone (818) 625-5507
E-mail: [email protected]
www.royalswimteam.com
ROYAL SWIM TEAM
CREDIT CARD PAYMENT AUTHORIZATION FORM
Credit Card Information
Name on Card:
Credit Card Type:
Credit Card Number:
Expiration Date:
3-digit security code
(back of card):
Master Card:
VISA:
Month:
Year:
Credit Card Billing Address
First Name:
Last Name:
Street Address:
City, State:
Zip code
Additional Contact Information
Phone Number:
Email Address:
Authorization:
I hereby authorize the Royal Swim Team to charge the above credit card on the 1st of each month in the amount of
$ ____.____ for a monthly swim team fee. I also agree to notify the Head Coach of the Royal Swim Team in writing to
terminate or inactivate my membership.
Print your name:
Date:
Signature:
Date:
All information is required to process your credit card payment.
Royal Swim Team Policies
Monthly Fees and Membership
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Monthly fees are due on the 1st of the month and are based on the swimmer’s group level. We do not prorate
monthly dues. We do not provide make up practices for missing days.
Annual Royal swim team NON REFUNDABLE membership fee $100 per member. Each additional sibling
is $50. Annual membership is not refundable.
Swimmers who choose not to attend workouts for a portion of the month are not entitled to a pro-rated fee.
All swimmers must register with Southern California Swimming a local swimming committee of USA
Swimming. Swimmers who have never participated on a USA Swimming registered team will be required to
show a birth certificate or passport as proof of age in order to register. Registration and annual renewal of
membership to Southern California Swimming is required for every swimmer. Through this membership
insurance coverage is provided for ROYAL swimmers and coaches. Membership in USA Swimming is
mandatory. USA Swimming membership for current members will be renewed automatically through
“TeamUnify” every October. Automatic annual membership renewal fee is $67.
Cancelation & Temporary Leave
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A member who decides to leave the team permanently must notify head coach in advance before the
beginning of the month. If you fail to notify before the 1st of the month, you will be charged. Royal Swim
Team takes annual two weeks off in August at the end of season. We do not prorate monthly fees for team’s
time off.
A swimmer who decides to leave the Royal Swim Team for any reason for full month or more may take leave
and pay a maintenance fee of $75 per month which will hold his/her place on the swim team. Member must
return the following month or forfeit his/her place on the team. A member who fails to pay maintenance fee
will forfeit his/her yearly membership.
Late Payments
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Dues became delinquent after the 5th day of each month.
Late charge of $20 will be assessed if payment is not received by the 5th each month.
Return Check fee is $30.
Declined credit card transaction fee is $15 per each declined transaction.
If the dues of a swimmer are still outstanding on the 15th of the billing month, the swimmer will not be
allowed to participate in workouts.
Royal Swim Team depends on revenue from dues to pay our coaches’ salaries, insurance, pool rental, etc. We
regret that we cannot afford for families to become delinquent in their payments or negotiate fees.
I acknowledge that I have read and agree to the above Royal Swim Team Polices and Conditions.
Name (please print)……………………………………….……………………
Signature…………………………………………………………..
Date………………………………
Publicity Release
Members of The Royal swim team automatically grant permission to The Royal Swim Team to use their image
in photos and videos for advertising and publicity purposes, inclusive of print advertising, educational videos,
videotaping, or film broadcast in connection with promotional campaigns.
Name (please print)……………………………………….……………………
Signature…………………………………………………………..
Date………………………………
Payment Method
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All payments MUST go through our secure electronic payment processing system “TeamUnify”. You can
use your credit/debit card and/or enable direct bank processing to pay your monthly dues and other
expenses.
It's simple to enable our electronic payment processing system. Simply visit our team website at
www.teamunify.com/scsrst to Sign In into your account. If you do not have a user name and password,
please click on (
) to request access from a team administrator. Once logged in: Click on My
Account
Then $ Payment Setup
Click on the pull down menu and select automatically charge CREDIT CARD or automatically charge my
BANK ACCOUNT
Click on the Edit link and fill in the data completely and Save Changes
Once that window closes, click Save Changes at the bottom right of the page
You are now ready to pay electronically!
You will receive monthly invoices outlining what your credit card or bank has been debited for and you
can review your current and past billing histories through the $ My Invoices/Payments tab on the left of
our team website.
Signature………………………………………………