Swimming Exemption Form
Student Full Name
*
First Name
Last Name
Parent's Information
*
First Name
Last Name
Parent's Primary Email
*
Parent's Phone Number
*
Please enter a valid phone number.
P E Instructor's Full Name
*
First Name
Last Name
P E Instructor's Email
*
P E Instructor's Phone Number
*
School Name
*
Please Select
Metea Valley High School
Neuqua Valley High School
Waubonsie Valley High School
Other
Please Specify Other School Name Here
Grade
*
Please Select
9 (Freshman)
10 (Sophomore)
11 (Junior)
12 (Senior)
Additional Information
Submit
Should be Empty: