(complete this form and bring to registration)


2008 Learn-to-Swim Registration
 
 
Name of participant: _____________________________  Age: ________
 
Address: _____________________________________________________
 
City: ____________ State: __________ Zip: _______
 
Home Number: __________________  Work Number: _________________
 
Email address: (required) ________________________________________
(Confirmation will only be sent through email notification)
 
Indicate which is the best place to call: Home or Work-Circle one
 
Name of Parent or Guardian: ______________________________________
 
Pool Location: __________________________________________________
 
Date: ______________________________ Time: ______________________
 
Level enrolling: __________________________________________________