Master Swim Team Sign Up Intake Form
Please fill out the questions below to complete your registration for Master Swim Team. This program is a month by month basis! Each month is $70.00 per month ($35.00 per month for members)! You will have the option to set up recurring payments or pay month by month. 

FIRST WEEK IS FREE
FIRST MONTH IS $40.00 FOR NON-MEMBERS AND $20.00 FOR MEMBERS

Locations:
Roswell Aquatic Center (M/W/F 5:30am-6:30am)
(Other locations coming soon)

For any questions please email Coach Jonny [jbooth@northsideswimacademy.com] or call 678-208-3629 ext. 704 M-F 8:00am-8:00pm.

NOTE: THIS INTAKE FORM IS FOR YOU TO COMPLETE YOUR SIGN UP! YOUR SIGN UP WILL NOT BE COMPLETE AND YOU WILL NOT BE REGISTERED OFFICIALLY UNTIL THIS SIGN UP FORM IS COMPLETE! AFTER THIS IS COMPLETE, YOU WILL RECEIVE A CONFIRMATION EMAIL THAT YOUR SIGN UP HAS BEEN COMPLETED!
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What is your name (first and last)? *
What is your DOB *
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DD
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YYYY
What is your email? *
What is your phone number? *
If you would like to provide an emergency contact, please do so below (first and last name, number, and email)
Describe your swim level in a few sentences *
Are there any injuries, medical conditions, or disabilities that our coaches need to be aware of? If yes, please describe below. If no, write N/A *
What area are you interested in? *
Required
If you are waiting for another location, where do you reside? *
Would you be interested in any of our other forms of programing? (select all that apply) *
Required
Did anyone refer you (NSA staff or a friend)? If yes, what is their name? (If no write N/A) *
How did you hear about us? *
Would you be interested in a membership with us? *
By checking the box below I am agreeing to all the rules and regulations set by Northside Swim Academy and whichever facility Northside Swim Academy has partnered with. I understand that all rules and regulations can be found on our website and in more depth in our handbook/information pack (located on home page). *
Required
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