Swim Lesson Registration

Child's Name *

Child's Age*

Child's Birthdate*

Please select session(s) that you would like to register your child for*
June 4-14 9:30-10:00am
June 4-14 10:00-10:30am
June 18-28 9:30-10:00am
July 9-19 9:30-10:00am

Please describe your child's swimming ability:*

Member Name *

Member Number*

Email Address*

Emergency Contact Number *

* Indicates a required field.