Registration for swim lessons

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September 2 - 11, 2025 in the afternoon (approx 2p - 6p)
Phoenix, AZ

(time assignment and exact address will be provided 5-7 days before the start of lessons)

Mom's Name *

First and Last names

Mom's e-mail address *

Dad's Name *

First name only... last name if different from Mom's

Phone numbers (please provide at least two) *

Number and Type (home, cell, work, etc)

Address *

House number and Street, City, State, ZIP

Child Information (First name, Gender, and Date of Birth... last name only if different from Mom) *

(Please list all children, even if not taking lessons. Mark swimmers taking lessons with a star ' * ')

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