The Aquatic Connection, LLC Online Registration

Registration

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Welcome to The Aquatic Connection!

Please complete the following registration form to enroll in swim lessons with TATS Kids' Swim School or Red Cross Aquatic Certification Programs with The Aquatic Training Academy!

* 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*

Primary Phone*

Additional Info

Gift Card Code

Contact #1

Parent/Guardian First Name*

Last Name *

Relationship*

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

Emergency Contact First Name*

Last Name*

Relationship*

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 Pronouns*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Any Limitations?

Any Allergies?

Any Medications?

Student Age*

Student Address*

Please click on the Select Class button below, then choose the class.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender Pronouns*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Any Limitations?

Any Allergies?

Any Medications?

Student Age*

Student Address*

Please click on the Select Class button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender Pronouns*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Any Limitations?

Any Allergies?

Any Medications?

Student Age*

Student Address*

Please click on the Select Class button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender Pronouns*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Any Limitations?

Any Allergies?

Any Medications?

Student Age*

Student Address*

Please click on the Select Class button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender Pronouns*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Any Limitations?

Any Allergies?

Any Medications?

Student Age*

Student Address*

Please click on the Select Class button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

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

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

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