Swimmer's Name
First Name
Last Name
Parent’s Name(s)
Contact Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth- MUST BE 4 YRS OLD
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Sibling
**Sibling to match with
Sibling's Name
First Name
Last Name
Date of Birth MUST BE 4 Yrs Old
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Day Selection (please check all that apply)
Wednesday
Thursday
Payment Amount: Wednesday & Thursday $130-Family Rate $240
*
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( X )
USD
October Swim Session
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
Pool School Swim Lesson
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