New SwimAmerica Swimmers and/or Divers
Registration Form

Bring this sheet to Open Registration: Thursday, August 6th, 10:00am to 1:00pm. Including the information on this form will help to speed up the process.

This form will be used only for the first session. You will need to register at the pool (at the Open Registration time) for any subsequent session(s).

Name ________________________________________________ Age __________________

Name ________________________________________________ Age __________________

Name ________________________________________________ Age __________________

Parents' Name(s) _______________________________________________________________________________

Address ________________________________________________________________________________

________________________________________________________________________________

Zip ___________________________

Daytime Phone ___________________     Alternate Contact Phone (cell) ______________________