Aquatic Abilities Online Registration

Registration

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Welcome to Aquatic Abilities! We are excited to have your child swim with us! A confirmation email will be sent after registering. If you have any questions or need assistance, please contact us at info@aquaticabilities.com. **If registering for a lifeguarding course, please enter the participant's information as the primary contact & student.**

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Account Information

Account Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Contact #1

Primary Contact First Name*

Last Name *

Type (parent, participant, etc.)*

How Can We Contact You?

Home Phone *

Work #

Cell #

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Secondary Contact First Name

Last Name

Type (grandparent, caregiver, etc.)

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Student Start Date

Please click on the Search button below. Once the classes pop up, select the magnifying glass icon in the top left to filter by session, level, etc. Then choose the class you would like to enroll in.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Student Start Date

Please click on the Search button below. Once the classes pop up, select the magnifying glass icon in the top left to filter by session, level, etc. Then choose the class you would like to enroll in.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Student Start Date

Please click on the Search button below. Once the classes pop up, select the magnifying glass icon in the top left to filter by session, level, etc. Then choose the class you would like to enroll in.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Student Start Date

Please click on the Search button below. Once the classes pop up, select the magnifying glass icon in the top left to filter by session, level, etc. Then choose the class you would like to enroll in.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Aquatic Abilities. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Student Start Date

Please click on the Search button below. Once the classes pop up, select the magnifying glass icon in the top left to filter by session, level, etc. Then choose the class you would like to enroll in.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

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*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

Registration

Referral Information

Account Information

Where do you live?

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

eCheck/Bank Draft

Required Policies

(Show-Hide Details)