Oconee Flippers Online Registration

Welcome to Oconee Flippers!
Please complete the following registration form.

New Swimmer Registration: Please log in to the Parent Portal to register for a Free Swimmer Evaluation. If you do not see a day/time that works for you, please message an Admin for further assistance.

Returning Swimmers: We will reach out to get your swimmer(s) lesson day/time on your schedule

* 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 *

Relationship to Student*

How Can We Contact You?

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*

Relationship to Student*

How can we contact you?

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)*

Allergies- type NONE if N/A*

Medications (Leave blank if NONE)

Immunizations YN*

Media Release Agreement Y/N*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)*

Allergies- type NONE if N/A*

Medications (Leave blank if NONE)

Immunizations YN*

Media Release Agreement Y/N*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)*

Allergies- type NONE if N/A*

Medications (Leave blank if NONE)

Immunizations YN*

Media Release Agreement Y/N*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)*

Allergies- type NONE if N/A*

Medications (Leave blank if NONE)

Immunizations YN*

Media Release Agreement Y/N*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)*

Allergies- type NONE if N/A*

Medications (Leave blank if NONE)

Immunizations YN*

Media Release Agreement Y/N*

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

Payment Options*

Please fill out CREDIT CARD Payment Method

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

Payment Information

Account Information

Required Policies

(Show-Hide Details)