Lorraine Swim Team Registration
To sign up to swim for the 2019 Lorraine Dolphins. Must still pay registration fee to the Evansville Parks & Recreation at the pool prior to the second swim meet. The price is $45 per swimmer.
Swimmer's First Name *
Your answer
Swimmer's Last Name *
Your answer
Swimmer *
Swimmer's Age will be at  July 1, 2019 *
Your answer
Swimmer's Birthdate *
MM/DD/YYYY
Your answer
Swimmer's Street Address *
Your answer
Swimmer's City *
Your answer
Swimmer's State *
IN
Your answer
Swimmer's Zip Code *
Your answer
Swimmer's Contact Phone # *
xxx-xxx-xxxx
Your answer
Swimmer's Contact e-mail address *
Your answer
Has swimmer swam competively within the last year? *
ex. GREAT, Newburgh Sea Creatures, High School team
Required
If Yes above, what was the date of the last meet?
This is a recreation league & swimmer cannot swim competively.
MM
/
DD
/
YYYY
Parent/Guardian 1 First Name
Your answer
Parent/Guardian 1 Last Name
Your answer
Parent/Guardian 2 First Name
Your answer
Parent/Guardian 2 Last Name
Your answer
First Name of person bringing swimmer
Your answer
Last name of person bringing swimmer
Your answer
Emergency Contact Name *
First name Last Name
Your answer
Emergency Contact Phone Number *
xxx-xxx-xxxx
Your answer
Emergency Contact Relationship *
Required
Volunteer Assistance *
Every swimmer requested to have an adult help 1 time. See Descriptions on Booster Club page.
Required
If selected Other above:
Please describe assistance.
Your answer
Name of Volunteer *
Your answer
Email address of volunteer *
Your answer
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