Houston Hydra Swim Team Online Registration

Registration

Already a customer? Click here to login.

Welcome to Houston Hydra Learn to Swim! ***This registration is for Learn to Swim only *** Jackrabbit is not integrated with Teamunify. You will need to create a new Log-in. DO NOT SELECT the "Already a customer? click here" option above. After completing the following registration form, you will be redirected to the Houston Hydra web portal to complete basic information and receive important email notifications. You may contact Learntoswim@houstonhydra.com regarding any questions.

* 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

Emergency Contact Info (Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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

Contact #2 First Name

Last Name

Type

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

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor and Contact Information*

Please click on the Search button below, then choose two lesson days/times.

For example, Mon 5:00 - 5:30 Instructor and Wed 5:00 - 5:30 Instructor

Once you choose two lessons, this will be your schedule. ***Please do NOT choose more than two, or ALL of your classes will be dropped.***

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

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor and Contact Information*

Please click on the Search button below, then choose two lesson days/times.

For example, Mon 5:00 - 5:30 Instructor and Wed 5:00 - 5:30 Instructor

Once you choose two lessons, this will be your schedule. ***Please do NOT choose more than two, or ALL of your classes will be dropped.***

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

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor and Contact Information*

Please click on the Search button below, then choose two lesson days/times.

For example, Mon 5:00 - 5:30 Instructor and Wed 5:00 - 5:30 Instructor

Once you choose two lessons, this will be your schedule. ***Please do NOT choose more than two, or ALL of your classes will be dropped.***

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

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor and Contact Information*

Please click on the Search button below, then choose two lesson days/times.

For example, Mon 5:00 - 5:30 Instructor and Wed 5:00 - 5:30 Instructor

Once you choose two lessons, this will be your schedule. ***Please do NOT choose more than two, or ALL of your classes will be dropped.***

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

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor and Contact Information*

Please click on the Search button below, then choose two lesson days/times.

For example, Mon 5:00 - 5:30 Instructor and Wed 5:00 - 5:30 Instructor

Once you choose two lessons, this will be your schedule. ***Please do NOT choose more than two, or ALL of your classes will be dropped.***

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

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

(Show-Hide Details)