Registration

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Enjoy a night of movie and swimming with family! We provide the movie and floats and you bring the fun! Movies will be G to PG rated. Our movie will be displayed in a fully lit pool area with an abundance of guards. There will be an area to sit and enjoy the movie or you can swim around the shallow end of the pool. This will be available to Durfee Aquatics Families (and their guests) and will cost $1.00 per attendee.

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

Additional Information:

Enter your Full Name: