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2017 Hammerheads Clinic #1 Registration

Parent/Guardian Information

At least one parent/guardian registration is required.
New accounts will be sent an email confirmation message with instructions to setup a password.

At least one parent/guardian email address must be provided.
Check the boxes to indicate which parent/guardians should receive team-wide emails.

First Name * Last Name * Email Address *
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Primary Phone

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Athlete Information

Enter the information for each athlete being registered below. At least one Athlete registration is required.

First Name * Preferred Name Middle Initial Last Name * Gender * Birth Date *
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Home Address

Parent Consent/Release and Waiver of Liability

As the parent/legal guardian of my registered swimmer(s), I grant permission for the swimmer(s) to participate in all Herndon Hammerhead Swim Team activities. I agree and understand that swimming is a hazardous activity with many inherent risks. I, on behalf of myself and the swimmer(s), assume all risks and hazards incidental to the swimmer’s(s’) participation in the Herndon Hammerhead Swim Team activities, including but not limited to those risks arising from the transportation to and from such activities, and also do hereby release and waive all claims against the Herndon Hammerheads Swim Team, Herndon Swim Club, Claude Moore, Northern Virginia Swim League, and their respective coaches, team representatives, officers, volunteers, employees, agents, and fellow swim team participants, for any liability or injury resulting from the swimmer’s(s’) participation in the Herndon Hammerheads Swim Team program and activities. I, on behalf of myself and the swimmer(s), also agree to hold harmless and indemnify the entities, clubs, and persons named in this paragraph from all damages incurred arising from any claims related to the swimmer’s(s’) participation in the Herndon Hammerheads Swim Team activities.

I have read carefully and understand the significance of the foregoing and acknowledge on behalf of myself and the swimmer(s), my consent to and agreement with the terms of this Release and Waiver, by signing below

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