CLUB AFFILIATION TO AREA YEAR 2015 to 2016 AFFILIATION DUE: MARCH 1, 2015 CLUB (Name in Full) MAILING ADDRESS: POSTCODE CLUB WEBSITE : CLUB EMAIL : HEADQUARTERS: Pool Address: POSTCODE POOL TYPE 25 M 50 M LANES CLUB TIME TRIALS Club Time Trials are approved Yearly as part of this affiliation LANES INDOOR 25 M 50 M OUTDOOR 25 M 50 M SUMMER WINTER DAY: DAY: TIME: TIME: VENUE: VENUE: CLUB EXECUTIVES PRESIDENT SECRETARY TREASURER RACE SECRETARY NAME: HOME ADDRESS (Optional) CONTACTS HOME BUSINESS MOBILE FAX EMAIL ADDRESS NAME: HOME ADDRESS (Optional) CONTACTS HOME BUSINESS MOBILE FAX EMAIL ADDRESS NOTE: CLUB ADDRESS & EMAIL, INCLUDING NAME AND CONTACT DETAILS OF SECRETARY & RACE SECRETARY WILL BE ADVERTISED ON AREA WEBSITE UNLESS REQUESTED OTHERWISE CLUB MEETINGS CLUB AGM DAY VENUE TIME www.metroswnsw.swimming.org.au SMSW AFFILIATION 2015 - 2016 1 OF 2 "CLUB AFFILIATION TO AREA" CONTINUED CLUB REPRESENTATIVES 2015 - 2016 CLUB (Name in Full) DELEGATES (2 Maximum Voting, 2 Minimum noted) NAME CONTACT EMAIL NAME CONTACT EMAIL PROXY DELEGATES (2 minimum, to replace Delegate if needed) NAME CONTACT EMAIL COACHES AT CLUB HEAD COACH NAME ASS COACH CONTACT EMAIL NOTES Affiliation Forms (Pgs 1 & 2) are to be returned to SMSW Secretary by 1st March 2015, with Payment of $ 100.00 Area Clubs must be affiliated with NSW, before Area Affiliation is accepted Current Club Executives are to be noted on forms, when new AGM held an update must be sent to SMSW Club agrees to permit the Area to display unidentified photos or videos (NO NAMES / AGES / ADDRESS) of any Area Swimmer, in Area Website Area Presentation. INDIVIDUALS / CLUBS CAN NOTIFY AREA TO REVOKE THIS PERMISSION and Club agrees to assist the Area at any Swim Meet, including supply of Technical Officials. Clubs will be required to confirm hosting of Area Swim Meets, when scheduled SMSW USE ONLY AFFILIATION FORM RECEIVED: DATE: DATE: THESE FORMS ARE THE AFFILIATION INVOICE $ 100.00 FOR 2015 - 2016 AFFILIATION TO SNSW CHECKED BANK: CH / MO BSB ACC Y/N DATE: www.metroswnsw.swimming.org.au SMSW AFFILIATION 2015 - 2016 2 OF 2