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INDIANA SWIMMING CAMPS

Sept. 28, Bloomington, Indiana
Counsilman Billingsley Aquatic Center
1601 East Law Lane, Bloomington, IN 47408

CAMP COSTS

$300.00*

CAMP DETAILS - Download Camp flyer!

- Open to Boys and Girls 14-18 

SCHEDULE

- 9:30- 10 a.m. - Check-In at Pool

- 10-10:30 a.m. - Powerpoint Presentation from Coach Ray Looze

- 10:30 a.m. - 12 p.m. - First Swim Session

- 12-1:30 p.m. - Lunch on own

-1:30-2 p.m. - Check back in at pool

 2-4 p.m. - Second Swim Session

 Campers responsible for travel. lodging, meals/snacks

 

ADDITIONAL INFORMATION ON SUMMER CAMPS:

** For summer camps (not available for breaststroke clinic), we are offering an Elite segment as an option for 13 years and older. This segment of camp will feature an extra training session with a coach in the morning from 6-8 a.m. To learn more and participate in this Elite group, contact the Indiana Swim Camp soon after you register to reserve your spot! Space is limited!
Indiana Swim Camp Open to Ages 8-18

FOR REGISTRATION INFORMATION/INQUIRIES:

  • Office: 812-333-5684
  • E-Mail: For Further Information!
  • Download 2019 Fall Breaststroke Swim Clinic Flyer: Click Here!
  • Mailing Address: Indiana Swim Camp; 2394 Winding Brook Circle; Bloomington, IN 47401
  • Register On-Line: Now Available!


  • Add 6% for on-line registrations

    For questions about age restrictions, please E-Mail Us


      All Indiana Camps are open to all and any entrants



      2019 Indiana Breaststroke Clinic

      THIRD ANNUAL BREASTSTROKE CLINIC REGISTRATION - September 28, 2019

      Registration Note - Registrations will be accepted until the camp is full. No refunds or cancellations will be accepted after Sept. 14, 2019. Cancellations received before Sept. 14 will receive a refund of the registration fee minus a $75 administrative fee. No refunds will be made if a child is withdrawn after Sept. 14.

      If you have questions, please call 812-333-5684.

      Please complete the form below and submit camp payment.

       
      Camper's Name (Last, First)*
       
      Home Address*
       
      City*
       
      State*
       
      Zip*
       
      Paren/Guardian Name(s)*
       
      Camper's Home Phone*
       
      Parent's Cell*
       
      Parent's E-Mail Address*
       
      Age*
       
      HS Graduation Year (i.e. 2020)*
       
      Birthdate (Month/Day/Year)*
       
      Gender*
       
      Club Team Name
       
      Club Coach Name
       
      Best Time 50 Breast
       
      Best Time 100 Breast
       

      MEDICAL CONSENT FORM
      In order to enable the IU Health Center of Indiana University and/or other health facilities in Bloomington to provide prompt care to your minor son or daughter, please read and complete the below consent form. This way we can help your child without delay should an emergency occur. Additionally,please send us a copy of your child's insurance card and enclose it when returning all forms prior to your child's arrival at swim camp.
       
      Name of Minor*
       
      Insurance Company*
       
      Policy Number/Group #*
       
      Name of Policy Holder*
       
      Food Allergies
       
      Drug Reactions
       
      Present Medication (include dosage)
       
      Date of Last Tetanus Toxoid
       
      Any past or present illness, or injury or other information that would be useful in the event that treatment is needed
       
      Name and # to call if parent can't be reached*
       

      * I grant permission to the director, assistants, or other persons responsible for said minor to act on my behalf for said minor in granting permission for evaluation and treatment of medical problems. I understand that should a major medical problem arise, an attempt will be made to notify me by telephone. In the event that I cannot be reached, I hereby give my consent to such treatment as deemed necessary (including surgery, x-ray examinations, and anesthesia to be rendered to said minor by a licensed physician or nurse)  

      * I do herby, waive, release and discharge the Indiana Swim Camp, Forward Marketing LLC and respective staffs, employees, successors and assigns,of and from any and all rights and claims for damage resulting from injury of my person or property, which may be or arising out of my travelling to or from the Indiana Swim Camp. I/we, the parents/guardians, agree to the above waiver and release and we join therein.  

      * By my submission of this registration, I represent that I am either 18 years of age or older, or that I am the parent or legal guardian of the registrant (if he/she is under age 18). I represent I have read the terms of the Privacy Policy, that I understand the manner in which the information collected about the registrant may be used, and that I agree to the use of the registrant’s personally identifiable information in the manner described in the Privacy Policy.  

      Parent/Guardian Name*
       
      Date*
       


      PAYMENT OPTIONS
      Please select your payment option by indicating a '1' in the quantity field. We need a registration form and consents completed for each participant.

      Note: A charge from Hoosiersportscamps.com will appear on your credit card for your on-line registration. However, if any of the Indiana Swim Camps are canceled for any reason, refunds must be collected directly from Indiana Swim Camp, 2394 Winding Brook Circle, Bloomington, IN 47401. Phone 812-333-5684.
       
      Qty 
       $318.00 Individual Registration - Payment in Full