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Summer 2018 Tadpole Registration Form

Welcome to the 2018 Registration for Fairfax Tadpole Program. All team members must have a stockholding family membership at Fairfax Swimming Pool to participate. Those on the Fairfax Pool's New Family Waitlist with Access Privileges are also eligible for our Tadpole program. If you do not already have a stock certificate or waitlist number, please visit the Fairfax Swimming Pool website to become a member. 

Please use this form only for Tadpoles. If you are interested in the Swim and/or Dive Team programs, please click here.

Parent/Guardian Information

At least one parent/guardian registration is required.
New accounts will be sent an email confirmation message with instructions to setup a password.

At least one parent/guardian email address must be provided.
Check the boxes to indicate which parent/guardians should receive team-wide emails.

First Name * Last Name * Email Address *
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Primary Phone

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Athlete Information

Enter the information for each athlete being registered below. At least one Athlete registration is required.

First Name * Preferred Name Middle Initial Last Name * Gender * Birth Date *
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Home Address

Membership Stock Certificate or Waitlist #

Please provide your FSP Stock Certificate or Waitlist Number (please note this is not the same as your Member ID number). If you have not yet joined Fairfax Swimming Pool, please visit https://www.fairfaxpool.com to join. (Current members can find their stock certificate number on their membership cards or by logging into their account at https://www.fairfaxpool.com/membership-payinvoices.html.) *

Participation Waiver

As the parent(s)/guardian(s) of the above named child, I/we understand that the Fairfax Swimming Pool (FSP) Tadpole Coaches, Representatives, and Fairfax Swimming Pool, Inc. cannot accept responsibility for the health and medical care of Tadpole participants. The Tadpole program does not maintain medical records or medical information with regard to its participants other than the information provided by parent/guardian on this form and the Tadpole Coaches and Representatives are relying on the information provided on this form and by parent(s)/guardian(s) signature below that the Tadpole participant is in good health and able to participate in the Tadpole activities. The Tadpole team and the FSP does not maintain or administer emergency medicines or equipment (such as epi-pens or cardiac equipment). If a Tadpole participant has a medical condition which would require the use of such medicines or medical devices, the Tadpole participant’s parent(s)/guardian(s) are solely responsible for carrying and administering such medicines/medical equipment. In cases of medical emergencies, the Tadpole Coaches, Representatives and Pool lifeguards of the Pool are authorized by me/us to call 911.

Parent(s)/guardian(s) understand that the sports of swimming and diving are inherently potentially dangerous sports, and that notwithstanding the swim/dive coaches efforts to assure the safety of all swim/dive participants, participants may incur injuries as a result of their participation. We/I hereby agree to hold the Fairfax Swimming Pool, Inc., the FSP Tadpole coaches and Representatives and their directors, volunteers, and agents free from any and all liability, claims, judgments, demands or damages occurring as a result of the swim/dive participant’s participation in Tadpole activities, practices, and meets sponsored by the Fairfax Swimming Pool Tadpole Program.

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