Swim & Yoga Camp
Registration
Email address *
Child's Name *
Your answer
Child's date of birth: YEAR/Month/Date *
Your answer
Parent's Name *
Your answer
Address *
Your answer
Cell Phone Number *
Your answer
Email Address *
Your answer
Previous Swimming Experience *
Your answer
Child's physician's name: *
Your answer
Physician's phone number: *
Your answer
Please list any allergies: *
Your answer
Are vaccines up to date? *
Your answer
Does your child have any special needs or developmental delays that we need to take into account? *
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