Aquatics Registration 2022

Please register each child individually.
Child's Name *

First Name Last Name
Parent's Name *

First Name Last Name
Member Number *
E-mail *
Phone Number *

Area Code Phone Number
Child's Age *
(As of June 15, 2022)
Child's Gender *
Birth Date *

Month Day Year
Team(s)

Swim Dive Water Polo Synchronized Swimming Mighty Bandits/Preteam Mighty Bandits Splash Ball
Questions or Comments
Should be Empty: