Low Country Swim School Online Registration

Registration

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NOW ENROLLING FOR SUMMER SWIM LESSONS! ALL LOCATIONS! PLEASE, PLEASE READ THE POLICIES CAREFULLY! They contain important information regarding scheduling, payments, cancellations, and more. By registering, you agree to follow these guidelines. If anything is unclear, we’re happy to assist! "Please note: Once you register and are placed on the schedule, your account will be charged in full." Any Questions Contact our Office: O: 843-981-2885 E: info@lowcountryswimschool.com

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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 # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Low Country Swim School. 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

Contact #2 (Emergency) First Name*

Last Name*

Type*

How can we contact you?

Home Phone

Work #

Cell # * Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Low Country Swim School. 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*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

IMPORTANT: After completing the online registration, please be sure to include the following information in the comment section of your form:

Preferred Location (where you’d like lessons to take place)
Swimmer’s Current Skills (what they are comfortable doing in the water)
Preferred Days and Times (what works best for your schedule)

This helps us match you with the best class option as quickly as possible.

Need Help picking a class- No problem we are here to assist you!

Days and Times are NOT LISTED! Pick the class that fits your childs needs

Adaptive Classes are ONLY FOR SPECIAL NEEDS STUDENTS!

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

IMPORTANT: After completing the online registration, please be sure to include the following information in the comment section of your form:

Preferred Location (where you’d like lessons to take place)
Swimmer’s Current Skills (what they are comfortable doing in the water)
Preferred Days and Times (what works best for your schedule)

This helps us match you with the best class option as quickly as possible.

Need Help picking a class- No problem we are here to assist you!

Days and Times are NOT LISTED! Pick the class that fits your childs needs

Adaptive Classes are ONLY FOR SPECIAL NEEDS STUDENTS!

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

IMPORTANT: After completing the online registration, please be sure to include the following information in the comment section of your form:

Preferred Location (where you’d like lessons to take place)
Swimmer’s Current Skills (what they are comfortable doing in the water)
Preferred Days and Times (what works best for your schedule)

This helps us match you with the best class option as quickly as possible.

Need Help picking a class- No problem we are here to assist you!

Days and Times are NOT LISTED! Pick the class that fits your childs needs

Adaptive Classes are ONLY FOR SPECIAL NEEDS STUDENTS!

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

IMPORTANT: After completing the online registration, please be sure to include the following information in the comment section of your form:

Preferred Location (where you’d like lessons to take place)
Swimmer’s Current Skills (what they are comfortable doing in the water)
Preferred Days and Times (what works best for your schedule)

This helps us match you with the best class option as quickly as possible.

Need Help picking a class- No problem we are here to assist you!

Days and Times are NOT LISTED! Pick the class that fits your childs needs

Adaptive Classes are ONLY FOR SPECIAL NEEDS STUDENTS!

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

IMPORTANT: After completing the online registration, please be sure to include the following information in the comment section of your form:

Preferred Location (where you’d like lessons to take place)
Swimmer’s Current Skills (what they are comfortable doing in the water)
Preferred Days and Times (what works best for your schedule)

This helps us match you with the best class option as quickly as possible.

Need Help picking a class- No problem we are here to assist you!

Days and Times are NOT LISTED! Pick the class that fits your childs needs

Adaptive Classes are ONLY FOR SPECIAL NEEDS STUDENTS!

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)