Club Registration Form
Club Name _____________________________________________ Club Initials ____________
Club Address __________________________________________________________________
City ____________________________ State ________________ Zip _____________________
Phones(Voice/Fax)______________________________________________________________
E-mail Address ________________________________________________________________
Type of Club:
Head Coach’s Info:
Name ________________________________________________________
Home Address ________________________________________________________________
City ____________________________ State________________ Zip _____________________
Phones(Voice/Fax)_____________________________________________________________
E-mail Address________________________________________________________________
Club Members must have a minimum of 50 swimmers, 18 years old and under. Clubs must be independent of direct program controls of a college/university, YMCA, Jr./community college, high school/prep school. Club Members must be coached by a Coaching Member of the National Club Swimming Association. Such status will be determined by the Membership Committee of the NCSA.
By checking this box, the coach of this club, certify that we meet the requirements for membership in the National Club Swimming Association and have a minimum of 50 swimmer, 18 years and under.
