2019-2020 Season Sign On Form
Family Details
Mother's Name
Father's Name

Swimmer 1 Details
Swimmer 1 - Name
Swimmer 1 - New or Returning
Swimmer 1 - Gender
Swimmer 1 - Do you identify as Aboriginal or Torres Strait Islander?

Swimmer 2 Details
Swimmer 2 - Name
Swimmer 2 - New or Returning
Swimmer 2 - Gender
Swimmer 2 - Do you identify as Aboriginal or Torres Strait Islander?

Swimmer 3 Details
Swimmer 3 - Name
Swimmer 3 - New or Returning
Swimmer 3 - Gender
Swimmer 3 - Do you identify as Aboriginal or Torres Strait Islander?

Swimmer 4 Details
Swimmer 4 - Name
Swimmer 4 - New or Returning
Swimmer 4 - Gender
Swimmer 4 - Do you identify as Aboriginal or Torres Strait Islander?

Do you allow photos of your children to be placed on our website/facebook pages?
How did you hear about Rochedale Rays?
Payment Details

All memberships include up to two adults.

You will receive a confirmation email, including bank details to be used for Direct Deposit when you submit this form.

I will be making payment for the following...
I will be paying by:
Terms
  • I am willing that the above named child/children be enrolled as swimming members of the Rochedale State School Amateur Swimming Club and agree that such membership will be subject to the Charter of Operations, Rules and Procedures of the Club, as may apply from time to time.
  • I am, as parent or Legal Guardian, willing to accompany the above-mentioned child/children to the Club swimming meets and swimming carnivals conducted at home and away venues and understand that any child/children not accompanied by a parent, guardian or other designated adult can be refused admission in any events.
  • As the named parent/guardian above, I understand that I am awarded a non-swimming membership, which entitles me to attend Club General Meetings with voting rights.
  • I agree that membership of this Club is accepted only on the condition that the Queensland Department of Education, the Rochedale State School Parents & Citizens Association, it’s Sub Committees and/or their members and employees accept no liability whatsoever for death or personal injury to any member or damage to property of any member whilst he or she is participating in any activities organised by, controlled by or associated with the Rochedale State School Amateur Swimming Club.
Do you agree to the terms outlined above?