2020-2021 Registration Payments - New
This form is for individuals, not teams, to submit payment. A registration form must also be submitted to the Business Office for the process to be complete. See www.virginiaswimming.org/registration for the appropriate form.
Email
*
example@example.com
Club Code
*
My Products
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( X )
Premium Athlete Registration
$
81.00
Quantity
Flex Athlete Registration
$
20.00
Quantity
Flex Upgrade
$
61.00
Quantity
Non-Athlete Registration
$
71.00
Quantity
Seasonal Athlete Registration
$
42.00
Quantity
Subtotal
$
0.00
Shipping
$
0.00
Total
$
0.00
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Should be Empty: