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Year Round Swimming Registration
September 1, 2022 - August 31, 2023
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* 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 Contact's Phone
*
Your answer
Swimmers Group
*
Year Round (12 months) Age Group II ($120/month)
Seasonal (Pay Month to Month) Age Group II ($140/month)
Year Round (12 months) Age Group I ($140/month)
Seasonal (Pay Month to Month) Age Group I ($160/month)
Year Round (12 months) Senior Group ($200/month)
Seasonal (Pay Month to Month) Senior Group ($220/month)
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