Gwinnett Swim Online Registration

Student #1

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Email

T-Shirt Size*

If applicable, what school does this student attend?

Grade Level

Please list the primary person providing transportation for this student.*

List any special needs and/or disabilities: *

List dates of any seizure activity: *

List allergies, asthma or medical conditions: *

List the details/dates of aquatic accidents, near drownings, or resuscitation: *

Are the student's immunizations up to date?*

List student’s swimming experience/prior lessons/water accidents, etc.:

Silver Sneakers ID#:

DID YOU KNOW?

Gwinnett Swim offers an optional membership plan that includes Members Only Perks such as discounted class tuition, priority class enrollment, unlimited makeup classes, free adult open lap swim, and more. Check out our Membership Benefits tab on our website for more information, or ask the scheduling coordinator.

Ready to get swimming? Feel free to start looking for a class by clicking "SELECT CLASS" below.

Don't see what you're looking for, or have more questions? No problem! Leave us a note below, click "SUBMIT REGISTRATION" below and we will help you sort it out. You can also give us a call at 404-590-7946.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Email

T-Shirt Size*

If applicable, what school does this student attend?

Grade Level

Please list the primary person providing transportation for this student.*

List any special needs and/or disabilities: *

List dates of any seizure activity: *

List allergies, asthma or medical conditions: *

List the details/dates of aquatic accidents, near drownings, or resuscitation: *

Are the student's immunizations up to date?*

List student’s swimming experience/prior lessons/water accidents, etc.:

Silver Sneakers ID#:

DID YOU KNOW?

Gwinnett Swim offers an optional membership plan that includes Members Only Perks such as discounted class tuition, priority class enrollment, unlimited makeup classes, free adult open lap swim, and more. Check out our Membership Benefits tab on our website for more information, or ask the scheduling coordinator.

Ready to get swimming? Feel free to start looking for a class by clicking "SELECT CLASS" below.

Don't see what you're looking for, or have more questions? No problem! Leave us a note below, click "SUBMIT REGISTRATION" below and we will help you sort it out. You can also give us a call at 404-590-7946.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Email

T-Shirt Size*

If applicable, what school does this student attend?

Grade Level

Please list the primary person providing transportation for this student.*

List any special needs and/or disabilities: *

List dates of any seizure activity: *

List allergies, asthma or medical conditions: *

List the details/dates of aquatic accidents, near drownings, or resuscitation: *

Are the student's immunizations up to date?*

List student’s swimming experience/prior lessons/water accidents, etc.:

Silver Sneakers ID#:

DID YOU KNOW?

Gwinnett Swim offers an optional membership plan that includes Members Only Perks such as discounted class tuition, priority class enrollment, unlimited makeup classes, free adult open lap swim, and more. Check out our Membership Benefits tab on our website for more information, or ask the scheduling coordinator.

Ready to get swimming? Feel free to start looking for a class by clicking "SELECT CLASS" below.

Don't see what you're looking for, or have more questions? No problem! Leave us a note below, click "SUBMIT REGISTRATION" below and we will help you sort it out. You can also give us a call at 404-590-7946.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Email

T-Shirt Size*

If applicable, what school does this student attend?

Grade Level

Please list the primary person providing transportation for this student.*

List any special needs and/or disabilities: *

List dates of any seizure activity: *

List allergies, asthma or medical conditions: *

List the details/dates of aquatic accidents, near drownings, or resuscitation: *

Are the student's immunizations up to date?*

List student’s swimming experience/prior lessons/water accidents, etc.:

Silver Sneakers ID#:

DID YOU KNOW?

Gwinnett Swim offers an optional membership plan that includes Members Only Perks such as discounted class tuition, priority class enrollment, unlimited makeup classes, free adult open lap swim, and more. Check out our Membership Benefits tab on our website for more information, or ask the scheduling coordinator.

Ready to get swimming? Feel free to start looking for a class by clicking "SELECT CLASS" below.

Don't see what you're looking for, or have more questions? No problem! Leave us a note below, click "SUBMIT REGISTRATION" below and we will help you sort it out. You can also give us a call at 404-590-7946.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Email

T-Shirt Size*

If applicable, what school does this student attend?

Grade Level

Please list the primary person providing transportation for this student.*

List any special needs and/or disabilities: *

List dates of any seizure activity: *

List allergies, asthma or medical conditions: *

List the details/dates of aquatic accidents, near drownings, or resuscitation: *

Are the student's immunizations up to date?*

List student’s swimming experience/prior lessons/water accidents, etc.:

Silver Sneakers ID#:

DID YOU KNOW?

Gwinnett Swim offers an optional membership plan that includes Members Only Perks such as discounted class tuition, priority class enrollment, unlimited makeup classes, free adult open lap swim, and more. Check out our Membership Benefits tab on our website for more information, or ask the scheduling coordinator.

Ready to get swimming? Feel free to start looking for a class by clicking "SELECT CLASS" below.

Don't see what you're looking for, or have more questions? No problem! Leave us a note below, click "SUBMIT REGISTRATION" below and we will help you sort it out. You can also give us a call at 404-590-7946.

Enroll in Classes

Select Class

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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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

Account Information

Credit Card

eCheck/Bank Draft

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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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

Account Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)