Fill this form out and send with a check to:
Cecil Townsend
43695 Grant Road
Avondale, Colorado 81022
and you will be placed on the wait list.
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 ___________________________________________ Station # _______ Age __________
Name ___________________________________________ Station # _______ Age __________
Name ___________________________________________ Station # _______ Age __________
Parents' Name(s) _______________________________________________________________________________
Daytime Phone ___________________ Alternate Contact Phone (cell) ______________________