Water Otters Swim School Online Registration

Registration

Already a customer? Click here to login.

ALL NEW & RETURNING FAMILIES MUST COMPLETE THIS FORM!

After submitting, IT IS NECESSARY to pay for classes and complete your enrollment in the Parent Portal.

ENROLLMENT IS PENDING FOR ALL NEW FAMILIES who have never taken classes with Water Otters. After we receive your registration and/or enrollment, we will contact you to confirm your classes.

* 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 Name & Phone Number (other than parent or guardian)*

Is your family new to Water Otters Swim School? (Y/N)*

Contact #1

Parent #1 First Name*

Last Name *

Type*

How Can We Contact You?

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Water Otters 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

Parent #2 First Name

Last Name

Type

How can we contact you?

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Water Otters 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

Attends preschool? (If currently enrolled, please list school name below)

Disabilities/Physical Challenges? (N/A if none)*

Conditions which require accommodation (ADD/ADHD, Autism, Asthma, Ear Plugs, etc.)? N/A if none*

Please describe what specific accommodations your child may need. (if applicable)

Specific Goals or Expectations? (please list if applicable)

Submerges independently (Y/N)*

Swims independently (Y/N)*

Wears floatation device (Y/N)*

Previous water trauma/fears*

Access to a pool for practice?*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Attends preschool? (If currently enrolled, please list school name below)

Disabilities/Physical Challenges? (N/A if none)*

Conditions which require accommodation (ADD/ADHD, Autism, Asthma, Ear Plugs, etc.)? N/A if none*

Please describe what specific accommodations your child may need. (if applicable)

Specific Goals or Expectations? (please list if applicable)

Submerges independently (Y/N)*

Swims independently (Y/N)*

Wears floatation device (Y/N)*

Previous water trauma/fears*

Access to a pool for practice?*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Attends preschool? (If currently enrolled, please list school name below)

Disabilities/Physical Challenges? (N/A if none)*

Conditions which require accommodation (ADD/ADHD, Autism, Asthma, Ear Plugs, etc.)? N/A if none*

Please describe what specific accommodations your child may need. (if applicable)

Specific Goals or Expectations? (please list if applicable)

Submerges independently (Y/N)*

Swims independently (Y/N)*

Wears floatation device (Y/N)*

Previous water trauma/fears*

Access to a pool for practice?*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Attends preschool? (If currently enrolled, please list school name below)

Disabilities/Physical Challenges? (N/A if none)*

Conditions which require accommodation (ADD/ADHD, Autism, Asthma, Ear Plugs, etc.)? N/A if none*

Please describe what specific accommodations your child may need. (if applicable)

Specific Goals or Expectations? (please list if applicable)

Submerges independently (Y/N)*

Swims independently (Y/N)*

Wears floatation device (Y/N)*

Previous water trauma/fears*

Access to a pool for practice?*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Attends preschool? (If currently enrolled, please list school name below)

Disabilities/Physical Challenges? (N/A if none)*

Conditions which require accommodation (ADD/ADHD, Autism, Asthma, Ear Plugs, etc.)? N/A if none*

Please describe what specific accommodations your child may need. (if applicable)

Specific Goals or Expectations? (please list if applicable)

Submerges independently (Y/N)*

Swims independently (Y/N)*

Wears floatation device (Y/N)*

Previous water trauma/fears*

Access to a pool for practice?*

Add Another Student

Required Policies

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Questions or Concerns

Comments

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

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)