Registration
Fill out this form to reserve your family a space at our next Family Open Swim! You will not be charged until you attend the event. Cost: $10 per swimmer / Currently Enrolled Swim Families receive a 50% discount! *Swimmers must be at least a STEP 5 to swim without an adult in the pool.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
How many adults will be swimming?*
How many children will be swimming?*
What are the ages of the child(ren)?*
Would you like to borrow one of our Swim Vests (ages 1-6yr)?*
Are you a currently enrolled Swim Family (eligible to receive 50% off)?*
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*