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2020 Summer Swim Lessons Registration
Please complete one for each student.
Student Last Name *
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Student First Name *
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Student Birthdate *
MM
/
DD
/
YYYY
19-20 school attended
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Grade during 19-20 school year *
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School District You Reside In *
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Parent Name *
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Email
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Parent/Guardian Phone Number can be reached at during swim lesson *
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Address *
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City *
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State *
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Zip Code *
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1st Choice *
Child's Level (if known)
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