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Registration for Aqua Scots Swim and Dive
Child First and Last Name *
Your answer
Gender *
Date of Birth (MM/DD/YEAR) *
Your answer
Age as of last June
Your answer
Participating On*
Child is...
T Shirt Size
Member Last Name
Your answer
Member Number at Tartan Fields
Your answer
Parent's Email Address
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Address (Street, City, Zip Code)
Your answer
Parent #1 First and Last Name
Your answer
Call Phone*
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Parent #2 First and Last Name
Your answer
Parent #2 Phone Number
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Additional Email
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Additional Name: Nanny or Babysitter
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Nanny/Babysitter Phone
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Medical Release
I acknowledge that a medical release form must be completed for ALL swimmers (new and returning). We must have a completed form before child will be allowed to participate. A form will be emailed to you.
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