Register for Swim Week 
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Email *
First Name (Learner) *
Last Name (Learner) *
First Name (Parent/Guardian if Learner is under 18)
Last Name (Parent/Guardian if Learner is under 18)
Age of Learner   *
MUST be 5 years or older. Type "adult" if over the age of 18
Contact Number 1 *
Contact Number 2
Beach Location
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Time *
Please choose your preferred class time
A copy of your responses will be emailed to the address you provided.
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