Year Round Swimming Registration
September 1, 2020 - August 31st, 2021
* Required
Name of Athlete: First Name
*
Your answer
Middle Name
*
Your answer
Last Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Age
*
Your answer
Grade
*
1
2
3
4
5
6
7
8
9
10
11
12
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
Emergency Contact
*
Your answer
Emergency Contract's Phone
*
Your answer
Swimmers Group
*
Age Group II ($120/month)
Age Group I ($140/month)
Senior Group ($180/month)
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