Patriot Aquatics Online Registration

Registration

Already a customer? Click here to login.

Welcome! Please complete the following registration form. Participated in our programs last year? Click the button above to access your account.

*All discounts (multi-children or multi-week) will be applied at checkout in the parent portal. Please log into your parent portal account to submit your registration payment after completing this form. No payment will be run until you login to your parent portal and submit the registration payment after completing this form.

* 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*

Contact #1

First Name*

Last Name *

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

First Name

Last Name

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

T-Shirt Size

Approved adults(s) for pick up (Required for splash camp ONLY)

Special Needs (Leave blank if NONE)

Allergies (Required for splash camp ONLY)

Medications Required (Required for splash camp ONLY)

Please click on the "select class" button below if you are registering for splash camp or summer league.

NOTE: Swim lessons will NOT be listed below. Please continue to complete the registration form and leave any important information (site location, lesson type, preferred lesson session, preferred lesson time, special needs, etc) in the comments section below. We will contact you directly within 24 business hours to finalize your registration.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Approved adults(s) for pick up (Required for splash camp ONLY)

Special Needs (Leave blank if NONE)

Allergies (Required for splash camp ONLY)

Medications Required (Required for splash camp ONLY)

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Approved adults(s) for pick up (Required for splash camp ONLY)

Special Needs (Leave blank if NONE)

Allergies (Required for splash camp ONLY)

Medications Required (Required for splash camp ONLY)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Approved adults(s) for pick up (Required for splash camp ONLY)

Special Needs (Leave blank if NONE)

Allergies (Required for splash camp ONLY)

Medications Required (Required for splash camp ONLY)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

T-Shirt Size

Approved adults(s) for pick up (Required for splash camp ONLY)

Special Needs (Leave blank if NONE)

Allergies (Required for splash camp ONLY)

Medications Required (Required for splash camp ONLY)

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Liability Waiver

By registering my child(ren) with Patriot Aquatics, I agree to participate (or allow my child(ren) and family members to participate) in Patriot Aquatics, and hereby release and hold harmless Patriot Aquatics, The School Board of Seminole County, The City of Altamonte Springs, their officers, directors, and employees, from liability for any injury or cost incurred while participating in the Patriot Aquatics program.

I've read the above and agree.

Medical Release Waiver

I certify that I am the parent or legal guardian for my child(ren). I hereby give my permission for any supervisor, coach or other team administrator associated with the Patriot Aquatics to seek and give appropriate medical attention for our child(ren) in the event of accident, injury, illness. I will be responsible for any and all costs associated with any necessary medical attention and/or treatment.

I hereby waive, release and forever discharge Patriot Aquatics from all rights and claims for damages, injury, loss to person or property which may be sustained or occur during participation in Patriot Aquatics activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my children is (are) physically fit and capable of participation in all activities.

I've read the above and agree.

Payment Policy

Applicant acknowledges that he/she understand the payment policy (see below) of Patriot Aquatics and therefore agrees unpaid dues and all other unpaid items will be charged to the credit card on file.

Payment Policy:
All fees are due at registration.
You may transfer your reserved week (camp) or session (lessons) if we are given a 72 hour notice prior to the start of the week you are registered for.
NO refunds will be given.

I've read the above and agree.

Photo Release Consent Waiver

I understand that photos of my child(ren) may be taken during swim lessons, swim league, or splash camp and may be used in future publicity or on the Patriot Aquatics website.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

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*