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REGISTER
REGISTRATION REQUEST FORM
Parent First Name
Parent Last Name
Email
*
Phone
First and Last Name of Swimmer
*
Birthday
Month
Month
Day
Year
Are there any medical conditions we should be aware of?
*
Level of swimmer
Summer Sessions: Please select your dates of choice below
Fall Sessions: Please select your dates of choice below:
Please select your requested time below
4:00 pm
4:45 pm
5:30 pm
6:15 pm
Class Preference
*
Submit
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