APPLICATION – SNS All-Stars

SIERRA NEVADA SWIMMING

“Mostly” Civil War: 2021 SNS All-Star Meet Recruit Information & Medical Release
All Recruits named to the 2021 Sierra Nevada All-Star Roster and competing from Saturday, July 31, 2021 through Sunday, August 1, 2021, MUST submit the following information.
Name of Recruit *

First Name Last Name
*

Male Female
Date of Birth *

Month Day Year
Date
Age as of 7/31/2021 *
USA Swimming Number *
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent 1 *

First Name Last Name
Parent 1's Phone Number *
Please enter a valid phone number.
Parent 1's Email *
example@example.com
Parent 2

First Name Last Name
Parent 2's Phone Number
Please enter a valid phone number.
Parent 2's Email
example@example.com
Club Team Name
Club Coach's Name

First Name Last Name
Club Coach's Phone Number
Please enter a valid phone number.
T-Shirt Size *

Youth - S Youth - M Youth - L Adult - S Adult - M Adult - L Adult - XL
Windbreaker Size *

Youth - S Youth - M Youth - L Men's - S Men's - M Men's - L Men's - XL Women's - S Women's - M Women's - L Women's - XL
I will participate as a Recruit of the Sierra Nevada All-Star Roster. I agree to abide by the guidelines and Code of Conduct and other necessary rules and guidelines set forth by the SNS Central Command (coaching staff, chaperones, & team staff) If I do not abide by the team guidelines and Code of Conduct and other necessary rules and guidelines, I understand that I will be sent home prior to the conclusion of the Omega Level Event (2021 SNS All-Star Meet).

To defray costs, each Recruit, during the application process, was asked to contribute a co-pay of $100. Once an Athlete is selected as a Recruit to the SNS All-Star Roster, the co-pay is NONREFUNDABLE.

Recruits will receive Squad Gear (swim caps, T-shirts, Speedo backpack, etc) specific to their assignment to either Team Chicken or Team Miner. Families will be responsible for transporting the Recruit to and from the Omega Level Event.
Recruit's Name *

First Name Last Name
Recruit's Signature *

Clear
Parent Name *

First Name Last Name
Parent Signature *

Clear
Sierra Nevada IS THE MEET HOST for this Omega Level Event. We will need parent involvement to be able to offer this unique experience to our Recruits.
Are you willing to serve as a Parent Volunteer

Yes No
Signups for Volunteer Positions (Officials, Runners, Timers, Setup, etc) will be released on the SNS All-Star Website https://sns-allstars.com/ prior to the event.
SIERRA NEVADA RECRUIT HONOR CODE

Each athlete or staff member of any team representing Sierra Nevada Swimming during any LSC sponsored event (which includes travel to the meet, the duration of the competition, as well as travel back from the meet) is required to sign Sierra Nevada’s Swimming Honor Code. All issues as set forth within the Honor Code apply to all swimmers, officials, coaches and adult chaperones unless otherwise designated.

I, as a member and/or participant of Sierra Nevada Swimming understand and will comply with the following as approved by the Sierra Nevada Swimming Board of Directors:
1. The possession by any athlete or the use of alcohol, tobacco products, or controlled substances is prohibited throughout the event.
2. As an adult representative of Sierra Nevada Swimming as a Coach, Parent Chaperone or Official, the possession of a controlled substance is prohibited throughout the participation of the trip. Additionally, there will be no use of alcohol or tobacco products around the athletes at any time.
3. As to all athletes, attendance is required at all team functions which include, but are not limited to, meetings, practices, exhibitions, press conferences, and competitions unless otherwise excused or instructed by the head coach, the head chaperone, or designated person in charge of the team.
4. As to all adult chaperones, attendance is required at all team functions which include, but are not limited to, meetings, practices, exhibitions, press conferences, and competitions unless, otherwise excused or instructed by the head chaperone, or designated person in charge of the team.
5. As to all coaching staff and adult volunteers the Head coach is in charge of all issues relating to the conduct of the meet and attendance by the athletes. Any and all questions or concerns are to be brought to the attention of the head coach. All decisions made by the head coach are final and are to be followed.
6. As to all adult chaperones, the Team Manager is in charge of all issues relating to the supervision and control of the athletes with the exception of those matters that fall within the head coaches authority. Any and all questions or concerns are to be brought to the attention of the Team Manager. All decisions made by the Team Manager are final and are to be followed. By agreeing to attend the meet as a chaperone, you understand and agree that you will not be allowed to chaperone your child or their age group.
7. Uniform requirements that are established will be followed.
8. Proper respect, sportsmanship, and courtesy toward coaches, officials, administrators, competitors, chaperones and the public will be displayed at all times.
9. The manner by which one behaves will present a positive image of Sierra Nevada Swimming and will provide an atmosphere to meet the competitive performance objectives.
10. Additional guidelines may be established as needed to assure the safety and well-being of the team members and will be adhered to during the event.
I understand that failure to comply with the Sierra Nevada Honor Code as set forth in this document or additions necessary for the safety and well-being of the team members may result in disciplinary action, which may include but is not limited to the following:

Recruits:
1. Disqualification from one or more events of the competition.
2. Dismissal from the team and return home at my own expense.
3. Reimbursement of all expenses paid by Sierra Nevada Swimming on your behalf relating to this event.
4. Disqualification from future Sierra Nevada sponsored activities pending Zone Board of Review.
All Coaches, Officials and Adult Chaperones:
1. Dismissal from the team and return home at my own expense.
2. Reimbursement of all expenses paid by Sierra Nevada Swimming on your behalf relating to this event.
3. Disqualification from future Sierra Nevada sponsored activities pending Zone Board of Review.
Athlete/Coach/Staff/Chaperone Signature *

Clear
Parent/Guardian Signature *

Clear
Please indicate action desired in the event of an emergency *

In the event of an accident or other emergency, when a parent is unavailable, I hereby authorize a representative of Sierra Nevada Swimming to make such arrangements as he/she considers necessary for my child to receive medical or hospital care including necessary transportation. Under such circumstances, I further authorize the physician below to undertake such care and treatment for my child, as he/she considers necessary. In the event said physician is not available at the time, I authorize such care and treatment to be performed by any licensed physician or surgeon. In the absence of a parent, call neighbor/friend/relative I do not choose the above statement and desire the following action
Name

First Name Last Name
Relationship
I choose the following action(s) be taken
Physician's Name

First Name Last Name
Physician's Phone Number
Please enter a valid phone number.
Physician's Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Insurance Carrier
Policy Number/Athlete ID Number
The undersigned hereby agrees to bear all costs incurred as a result of the foregoing desired action. *

Clear
Date *

Month Day Year
Date
MEDICAL HISTORY
Any Known Health Problems *

Yes No
Food Allergy? *

Yes No
If Yes, Describe Food Allergy/Allergies
Does Recruit Carry an Epi-Pen?

Yes No
Food Preference

Omnivorous Vegetarian Vegan
Other Food Info
Please check if there is a history of any of the following conditions

Frequent Colds Frequent Sore Throat Sinusitis Convulsions Bronchitis Abscessed Ears Asthma Hyperactivity Stomach Upsets Fainting Spells Diabetes Epilepsy
Penicillin or any other drug reactions
Current Medications
Any Other Known Diseases?
Any Medical Conditions in the Last 24 Months?
Do you give SNS Staff permission to administer any medications to my child? *

Yes No
Allowed Medications

Ibuprofen Tylenol Benadryl Tums Dayquil/Nyquil Cough Drops
Parent Signature *

Clear
Any Additional Comments or Information
****PLEASE NOTE: IF YOUR SWIMMER HAS A HISTORY OF ANY MEDICAL PROBLEMS WE WILL NEED A LETTER FROM HIS OR HER PHYSICIAN DETAILING THE EXACT MEDICAL AILMENT, ANY MEDICATION THAT HE/SHE MAY NEEd AND ANY SPECIAL CARE THAT HE/SHE MAY NEED.
Should be Empty:

SIERRA NEVADA SWIMMING

MEDICAL HISTORY