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
Date
Sibling
**Sibling to match with
Sibling's Name
First Name
Last Name
Date of Birth MUST BE 4 Yrs Old
-
Month
-
Day
Year
Date
Day Selection (please check all that apply)
Wednesday-Old Town Gym $130.00
Thursday-Old Town Gym $105
Private
Payment Amount: $130.00- Individual $105 Thursday $240.00- Family Rate (Wednesday only)
prev
next
( X )
USD
July Swim Session
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Join the FUN
Pool School Swim Lesson
Safety First, Fun Always!
Should be Empty: