Waterbabies Online Registration

Registration

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Welcome to Waterbabies! Please complete the below form to set-up your Waterbabies account.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)

Col. Athletic Club Member #

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 Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

Health Issues

Allergies

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

Health Issues

Allergies

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

Health Issues

Allergies

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

Health Issues

Allergies

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

Health Issues

Allergies

Add Another Student

Required Policies and Agreements

Liability Release

As the undersigned, I agree that myself, my children, heirs or guests hereby waive and release any and all claims for damages, liabilities, suits, costs or actions against Waterbabies, LLC, Vera Garibaldi, Columbia Athletic Club - Pine Lake, Columbia Athletic Club - Juanita Bay, Columbia Athletic Club - Silver Lake, Bellevue Aquatic Center, Waterbabies Aquatic Center and any employees or partners thereof.