Providing Information Online Will Speed the Registration Process

** Must be filled out to register - Payment and class selection must be completed in person or by phone.

Main Contact (Parent or Guardian)

** First Name     **Last Name 

** Home Phone             Cell/Work Phone  

First Swimmer Information       Second Swimmer Information


  Check if Participant is an Adult  

**Swimmers First Name 

 **Swimmers Last Name 

 **Birth Date Month 

 **Day  

 **Year  

Swimmers First Name 

  Swimmers Last Name 

  Birth Date Month  

  Day  

  Year  

 

Third Swimmer Information       Fourth Swimmer Information


Swimmers First Name 

 Swimmers Last Name 

 Birth Date Month 

 Day  

 Year  



Swimmers First Name 

 Swimmers Last Name 

 Birth Date Month 

 Day  

 Year  

 

Mailing Address

   **Address     **City    ** State     **Zip 
 
 

   **Email Address         Check only if you do not want to receive email reminders

  Additional Note to Staff  
 

  

>