Take The Plunge - 2019 Information Signup
Thank you for your interest in Take The Plunge, a children's lap swim program offered by Richmond Swims with a grant from the Make a Splash foundation. This session is only for families who can show proof of low income.

To register your child, please fill out the following form and we will contact you to confirm your registration.
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Email address *
Your answer
Home Street Address *
Your answer
City *
Your answer
Zipcode
Your answer
Phone Number (w/area code) *
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Age *
Your answer
Child's Race *
Required
School *
Does your child qualify for free or reduced lunch at school? *
Which of the following applies to the child's family (please bring proof of eligibility to first session):
How did you find out about Take the Plunge? *
Preferred session time
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