Charlotte Aquatics Online Registration

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Charlotte Aquatics..... Swim With Heart.

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Contact #1

Contact #1 First Name*

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Contact #2

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Student #1

Student's First Name*

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Additional Info

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Classes meet once per week for 30 minutes. Please choose a time that works the best for you since make-up classes are limited

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Student's First Name*

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Additional Info

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Medications (Leave blank if NONE)

Classes meet once per week for 30 minutes. Please choose a time that works the best for you since make-up classes are limited

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

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Student Gender*

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Classes meet once per week for 30 minutes. Please choose a time that works the best for you since make-up classes are limited

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

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Classes meet once per week for 30 minutes. Please choose a time that works the best for you since make-up classes are limited

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes meet once per week for 30 minutes. Please choose a time that works the best for you since make-up classes are limited

Enroll in Classes

Select Class

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

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