Swimmer *

First Name

Last Name

Favorite Strokes

Check all that apply. (Minnows and Sharks only.)

Butterfly

Backstroke

Breaststroke

Freestyle

Preferences

Check if your swimmer is interested in participating in relay races or acting as a Guppy Helper. A Guppy helper is an older, more advanced swimmer who will stay in the water within arms reach of our youngest swimmers during the Guppy races. Guppies often use a kickboard and are still learning to swim on their own.

Swimmer is interested in relays.

Swimmer is interested in being a Guppy Helper.

Parent *

First Name

Last Name

Phone *

(###)

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Parent #2 (Optional)

First Name

Last Name

Phone

(###)

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Name *

First Name

Last Name

Phone *

(###)

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Volunteer Agreement *

The LOA Swim Team is 100% dependent on parent volunteers. As a member of the team, I agree that our family will participate in a committee and actively volunteer at a minimum of 3 meets.

Committee Chairperson

I would like to volunteer as a Committee Chairperson for the following committee:

Concessions Committee

Scorer Committee

Line Lane Judge/Runner Committee

Timer Committee

Awards Committee

Lindsay's Law *

All youth athletes and their parents/guardians are required to view the Ohio Department of Health (ODH) video about Sudden Cardiac Arrest found at (https://www.youtube.com/watch?v=s-YfCWQPeqw&ab_channel=OhioDepartmentofHealth) and review the ODH SCA handout (found at https://odh.ohio.gov/know-our-programs/lindsays-law/resources/required-sca-informational-handout-parents-guardians) and then sign and return the form. An electronic signature approval is also okay. What is Lindsay’s Law? Lindsay’s Law is about Sudden Cardiac Arrest (SCA) in youth athletes. It covers all athletes 19 years or younger who practice for or compete in athletic activities. Activities may be organized by a school or youth sports organization. Which youth athletic activities are included in Lindsay’s law? • Athletics at all schools in Ohio (public and non-public) • Any athletic contest or competition sponsored by or associated with a school • All interscholastic athletics, including all practices, interschool practices and scrimmages • All youth sports organizations • All cheerleading and club sports, including noncompetitive cheerleading What is SCA? SCA is when the heart stops beating suddenly and unexpectedly. This cuts off blood flow to the brain and other vital organs. People with SCA will die if not treated immediately. SCA can be caused by 1) a structural issue with the heart, OR 2) an heart electrical problem which controls the heartbeat, OR 3) a situation such as a person who is hit in the chest or a gets a heart infection. What is a warning sign for SCA? If a family member died suddenly before age 50, or a family member has cardiomyopathy, long QT syndrome, Marfan syndrome or other rhythm problems of the heart. What symptoms are a warning sign of SCA? A young athlete may have these things with exercise: • Chest pain/discomfort • Unexplained fainting/near fainting or dizziness • Unexplained tiredness, shortness of breath or difficulty breathing • Unusually fast or racing heart beats What happens if an athlete experiences syncope or fainting before, during or after a practice, scrimmage, or competitive play? The coach MUST remove the youth athlete from activity immediately. The youth athlete MUST be seen and cleared by a health care provider before returning to activity. This written clearance must be shared with a school or sports official. What happens if an athlete experiences any other warning signs of SCA? The youth athlete should be seen by a health care professional. Who can evaluate and clear youth athletes? A physician (MD or DO), a certified nurse practitioner, a clinical nurse specialist, certified nurse midwife. For school athletes, a physician assistant or licensed athletic trainer may also clear a student. That person may refer the youth to another health care provider for further evaluation. What is needed for the youth athlete to return to the activity? There must be clearance from the health care provider in writing. This must be given to the coach and school or sports official before return to activity.

By checking this box I confirm that both my child and I have viewed the Ohio Department video about Sudden Cardiac Arrest and reviewed the ODH SCA handout.

I am choosing not to read or watch the video supplied under Lindsay's Law. I understand that by doing so, my child will not be able to participate on the Lakes of Aurora Swim Team.

Pool Pass *

I have a current LOA pool pass