Jr. Highlanders Registration
For Pre-K and Kindergarten Swimmers
Swimmer's First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Birth Date *
MM
/
DD
/
YYYY
Age *
Your answer
Grade *
Gender *
Address *
Your answer
City *
Your answer
State
Your answer
Zip Code *
Your answer
Parent's First Name *
Your answer
Parent's Last Name *
Your answer
Cell Phone *
Your answer
Home Phone
Your answer
Other Phone
Your answer
Email *
Your answer
T-Shirt Size *
Lake Highland Student *
Emergency Contact *
Your answer
Emergency Contract's Phone *
Your answer
Session
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This form was created inside of Lake Highland Preparatory School.