Green Mountain Swim Club 2017 Membership Registration
Email address *
Last Name *
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First Name (Parent 1) *
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First Name (Parent 2) *
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Street Address *
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City *
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State *
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State *
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Zipcode *
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Phone Number *
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email address (parent 1) *
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email address (parent 2)
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Child 1 Name
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Child 1 Age
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Child 2 Name
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Child 2 age
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Child 3 Name
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Child 3 Age
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Child 4 Name
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Child 4 Age
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Children 5 + Name(s)
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Children 5 = age(s)
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My child(ren) attend the following schools
Membership Dues *
Required
Swim Lessons
King Soopers Pool Card
New Members only: I was referred to the pool by the following family
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Liability Waiver *
Required
I have questions
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Payment Options *
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