2021 Swim Team Registration

Member Number *
Email Address*
Phone Number*
Child's Name *
Birthdate 00/00/00*
There is no question in my mind my child can swim the length of the pool without assitance*
My child would like to practice *
We would like to practice at *
Please list any allergies or health concerns your child may have
I know my child will NOT be able to attend
* Indicates a required field.
CAPTCHA ImageReload Image
Please enter secure code above:*