Ocean First Divers Online Registration

Registration

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Welcome to The Ocean First swim family!

Please list all family members that will swim us in the 'Student' section. You only need to provide medical information that will affect you/your child during swim class. If you are a PLAYpass family, write 'PLAYpass' in the comments section.

Carefully read the policy information to be aware of tuition payment deadlines and other important policies

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Student Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (please list any other guardians/care-givers)*

Cell Phone

Additional Phone

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Pronouns

Birth Date*

Additional Info

School (Youth) / Employer (Adults)*

Relevant Medical Information

Special Accommodations

Allergies

Relevant Medications

Preferred Name/Nickname

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Pronouns

Birth Date*

Additional Info

School (Youth) / Employer (Adults)*

Relevant Medical Information

Special Accommodations

Allergies

Relevant Medications

Preferred Name/Nickname

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Pronouns

Birth Date*

Additional Info

School (Youth) / Employer (Adults)*

Relevant Medical Information

Special Accommodations

Allergies

Relevant Medications

Preferred Name/Nickname

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Pronouns

Birth Date*

Additional Info

School (Youth) / Employer (Adults)*

Relevant Medical Information

Special Accommodations

Allergies

Relevant Medications

Preferred Name/Nickname

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Pronouns

Birth Date*

Additional Info

School (Youth) / Employer (Adults)*

Relevant Medical Information

Special Accommodations

Allergies

Relevant Medications

Preferred Name/Nickname

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

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

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

Additional Info

Student #5 (Show-Hide Details)

Additional Info

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

(Show-Hide Details)