Year Round Swimming Registration

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September 1, 2025 - August 31, 2026

Name of Athlete: First Name *

Middle Name *

Last Name *

Birth Date *

YYYY

Age *

Grade *

Address *

City *

State

Zip Code *

Parent's First Name *

Parent's Last Name *

Cell Phone *

Home Phone

Other Phone

Email *

Emergency Contact *

Emergency Contact's Phone *

Swimmers Group *

Year Round (12 month contract) Age Group II ($130/month)

Seasonal (Pay Month to Month) Age Group II ($150/month)

Year Round (12 month contract) Age Group I ($155/month)

Seasonal (Pay Month to Month) Age Group I ($175/month)

Year Round (12 month contract) Senior Group ($200/month)

Seasonal (Pay Month to Month) Senior Group ($220/month)

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This form was created inside of Lake Highland Preparatory School.