Aqua Wave Swim School Online Registration

Welcome to AQua Wave Swim School! We are thrilled you are here! Please complete the following registration form so that we may get you in the water with one of our incredible instructors!

* 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*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # * Receive Text Message Notifications

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 # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

What days and times are you looking for to enroll your child? (Multiple days & Times preferred.)*

What type of Classes are you looking for?*

How Many times per week would you like to attend?*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

What days and times are you looking for to enroll your child? (Multiple days & Times preferred.)*

What type of Classes are you looking for?*

How Many times per week would you like to attend?*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

What days and times are you looking for to enroll your child? (Multiple days & Times preferred.)*

What type of Classes are you looking for?*

How Many times per week would you like to attend?*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

What days and times are you looking for to enroll your child? (Multiple days & Times preferred.)*

What type of Classes are you looking for?*

How Many times per week would you like to attend?*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

What days and times are you looking for to enroll your child? (Multiple days & Times preferred.)*

What type of Classes are you looking for?*

How Many times per week would you like to attend?*

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Registration

Referral Information

Family 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

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

Additional Info

Student #5 (Show-Hide Details)

Additional Info

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)