Water Otters Swim School Online Registration

Registration

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Welcome! ALL 2025 FAMILIES MUST complete this form in order to proceed & create your account in our new Parent Portal. The Parent Portal is where you will be able to pay for classes as well as view your account details. If you are a NEW FAMILY who has NEVER taken classes with Water Otters, please know that your enrollment is PENDING (even if payment has been processed). After we receive your registration request we will contact you to complete and finalize your enrollment.

* 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

Parent #1 First Name*

Last Name *

Type*

How Can We Contact You?

Cell # *

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

How can we contact you?

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Attends preschool? (if yes, please list school name below)

Disabilities - put N/A if none (if applicable please provide specific details)*

Specific Needs - put N/A if none (if applicable please provide specific details)*

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 yes, please list school name below)

Disabilities - put N/A if none (if applicable please provide specific details)*

Specific Needs - put N/A if none (if applicable please provide specific details)*

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 yes, please list school name below)

Disabilities - put N/A if none (if applicable please provide specific details)*

Specific Needs - put N/A if none (if applicable please provide specific details)*

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 yes, please list school name below)

Disabilities - put N/A if none (if applicable please provide specific details)*

Specific Needs - put N/A if none (if applicable please provide specific details)*

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 yes, please list school name below)

Disabilities - put N/A if none (if applicable please provide specific details)*

Specific Needs - put N/A if none (if applicable please provide specific details)*

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

(Show-Hide Details)

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)