2015 Stroke Clinic, Spring and Long
Course Makos Registration Form
This form may be used for up to two swimmers in the same family.
If you have additional swimmers, another page may be printed and added.
SWIMMER INFORMATION
____________________________________________________________________________________________________________
Last Name
First Name
Middle Initial
Preferred Name
__________________________
Date of Birth
Gender: Male
Female
Stroke Clinic
____________________________________________________________________________________________________________
School District
School Name
Grade/Year in School in 2013-14
Affiliation: Returning MAKO Swimmer
New to USA Swimming
New to MAKOs, Transfer from another Swim Club
SECOND SWIMMER INFORMATION
____________________________________________________________________________________________________________
Last Name
First Name
Middle Initial
Preferred Name
__________________________
Date of Birth
Gender: Male
Female
____________________________________________________________________________________________________________
Anticipated Training Group
Assigned Training Group (for office use only)
____________________________________________________________________________________________________________
School District
School Name
Grade/Year in School in 2013-14
Affiliation: Returning MAKO Swimmer
New to USA Swimming
New to MAKOs Transfer from another Swim Club
*Pursuant to USA Swimming regulations, we cannot accept your membership on our team if you have any outstanding dues with another USA
Swimming club. You must resolve any financial matters with your previous team prior to joining the Makos. Please have the head coach of your
previous USA Swimming team sign above as acknowledgement of your transfer in good standing. In lieu of the head coach’s signature, you may
include written confirmation, such as an email, from the head coach documenting knowledge of your transfer and verifying that you are leaving your
previous USA Swimming club in good standing.
FAMILY/ACCOUNT INFORMATION
Family/Account Email Address**______________________________________________________________________________________
**This email address will be used as the primary email address for Team Unify log in, billing, and email communication.
Please list an email address that is checked on a regular basis.
Please list the parent or guardian that should be contacted first if there is a question about your account:
__________________________________________________________________________________
**Place completed form and copy of receipt in Terri Shannon’s mailbox**
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PARENT/GUARDIAN INFORMATION
Parent/Guardian 1
Parent/Guardian 2
Name
Address
City, State, & Zip Code
Home Phone Number
Work Phone Number
Cell Phone Number
Email Address
Employer
Job Title
Are you interested in becoming an official?
Do you have a special talent, skill, or
connection that you feel would benefit the
team?
If so, please explain.
Participation in the Miami University Aquatic Club (MUAC) program involves physical activity with risk of personal injury or damage to property; it is
the policy of Miami University Aquatic Club to require participants to execute this release form.
1. In consideration of and as a condition of being granted the opportunity to participate in this voluntary activity, I do hereby release and forever
discharge all trustees, officers, employees, and agents of Miami University who arranged, advised, or supervised any function of this activity for
myself and my heirs, executors, administrators, and assigns from all claims demands, actions, and causes of action for personal injury or any
other damage now existing or which may arise out of or be in any way related to their negligence or other conduct associated with this activity.
2. I do hereby also agree to acquire - prior to participation in this activity and maintain in force during the period in which the participant will be
engaged in this activity - a policy of health and accident insurance covering hospitalization and treatment for any injuries sustained as a result of
such activity. Such insurance shall be through an insurance company authorized and licensed to do business within the State of Ohio and shall
provide coverage sufficient for the risks presented by this activity.
3. I do hereby grant permission for MUAC and those acting pursuant to its authority to record, use, exhibit, and/or distribute video, photographic,
digital, or electronic images of the participant without compensation for any purpose which MUAC deems appropriate, including promotional or
advertising efforts.
4. Registration for the MUAC entitles the registered participant access to certain facilities during the set program schedule. Family members may
accompany the participant for the purpose of watching during the program’s scheduled practice time. This registration does not extend any
membership privileges to the Recreational Sports Center facilities for the participant or family members. Non-member participants deemed in
violation of this policy may be removed from the program and refused further registration. If interested in purchasing a Recreational Sports
Center Membership, please contact the Pro Shop at 513.529.8181.
I HAVE READ AND DO FULLY UNDERSTAND AND AGREE TO BE BOUND BY ALL OF THE ABOVE PROVISIONS.
______________________________________________________
Signature of Participant (if 18 years of age or older) or Parent/Guardian
Payment Information
 Payment of registration fees should be made separate from
payment of training group fees (i.e. two checks).
 Checks or money orders should be made payable to
____________________________________
Date


Miami University.
Payments will be made at the Pro Shop at the Recreational
Sports Center.
Credit card payments are accepted in person or over the phone
on credit card payment days.
MIAMI UNIVERSITY SWIM CLUB FEES CALCULATION WORKSHEET
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Please complete this form and return it with your registration so we know what fees to charge and discounts to apply to your account.
Keep a duplicate copy of this form for your records.
Long Course will be divided into three sections:
Stroke Clinic
The Makos stroke clinic will run April 27 - May 29. It is a five week progression geared toward 12 and under swimmers that are looking to clean up
their strokes before the start of the Summer Swim League. The clinic will meet three times a week, Monday, Wednesday and Friday, from 6-7p in the
Dive Well. The clinic will focus on a different stroke each week with the final week being a review as well as tips on starts and turns. It is
recommended that participants have had prior swim team experience or have completed level 4 of swim lessons.
Spring Session Makos
The spring session of Makos is focused around the competitive swimmer who will not be able to make the full commitment to the Long Course
season. In addition to drills and stroke critique, swimmers will also have workouts within practice. Swim practice will be Monday – Friday, April 13
through May 29 from 6-8p.
Long Course Makos
The Makos Long Course season is for the fully committed swimmer. This season will run from April 13 through the end of July. Swim practice will be
held at the Rec Center Monday through Friday from 6-8p. There will also be Saturday practices from 11a-1p when there isn’t a meet at the Rec.
Dryland training will be from 5:15-5:50p on Monday – Friday.
Once school is out of session, the schedule will be Monday, Wednesday and Friday, 8:30-10:30a and again 6-8p; Tuesday and Thursday. 2-4p .
Dryland training will be from 5:15-5:50p on Monday, Wednesday and Friday. Dryland training will be from 1:15-1:50p on Tuesday and Thursday.
Fee
First Swimmer
Each Additional Swimmer
Stroke Clinic **
$150
$135
Spring Makos
$225
$200
Long Course Makos
Silver
$500
$450
Gold
$575
$525
Payment Information and Options:
Payments will be made at the Pro Shop at the Recreational Sports Center.
Credit card payments are accepted in person or over the phone on credit card payment days.
Checks or money orders should be made payable to Miami University
Stroke Clinic and Spring Makos program fees must be paid on the athletes first day of practice.
Long Course Makos may be paid in one lump sum the first day of practice or may be divided into two payments due April 15 and May 1. Payroll
deduct is available for Miami employees.
Spring and Long Course Makos must be registered with USA Swimming. If your swimmer is not currently registered, there will be a $102 registration
fee in addition to the program fees.
Swimmer Name
List the swimmer in the highest training group first
Account
Members
Training Group
Annual
Training
Fee
Amount
Swimmer 1
Swimmer 2
If not a current USA Swimming Member, add $102
TOTAL AMOUNT DUE
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In signing this registration form, I acknowledge that I have read the above fees and declare my understanding that::
 I am enrolling my swimmer(s) in the Miami University Aquatic Club (MUAC), a competitive swim team.
 My registration fee of $102 for each swimmer is non-refundable, due with this document, and should be turned in before my swimmer attends
the first practice (includes optional practices). This is only due if not already a USA Swimming member of the Mako Swim Team.
 My registration will not be accepted if I have any unresolved payment issues from previous seasons.
 Registrations will only be accepted while there is room in the program.
 By enrolling in the MUAC, I am financially obligated to pay the total balance of my training fees as scheduled for the 2015 Stroke
Clinic, Spring Mako or Long Course Mako competitive training season (regardless of my attendance at practice). I do NOT have an
option to discontinue my financial obligation midway through the season.
 My swimmer(s) will be assigned to the training group(s) that the coaches’ feel will best fit the training level, ability, and skill of my swimmer(s).
 My payment of the training fees, or the first payment of the installment plan, is due by April 13, 2015. If my payment is not received by the due
date then late fees will accumulate at a rate of $10 per month beginning immediately after the due date and my swimmer will not be permitted to
participate until fees are paid (includes swim meets).
Entry fees for meets listed on the MUAC schedule are included in the cost of my training fees; however, if I have committed my swimmer(s) to a
swim meet that my swimmer(s) do(es) not attend (even if the team has suspended my swimmer(s) due to non-payment), I may be billed for
the cost of meet entry fees paid by the club for my swimmer(s).
 I acknowledge that I must volunteer (or provide a volunteer) for a minimum of four sessions for three day meets. If a family is unable
to fulfill this commitment, there will be a $50.00 fee assessed to the family per session that they cannot fulfill their commitment.
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