Enrollment Form
Person Filling Out Form
First Name
Last Name
Are you a Diamond Lake Yacht Club Member?
Yes
No
If you are the guest of a Diamond Lake Yacht Club Member, please enter their name.
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child 1
Name of Child Enrolling
First Name
Last Name
Age of Child
Has the child taken a class from us before?
Yes
No
Does the child have any health concrens?
Yes
No
If yes, please explain
Does this child have any allergies?
Yes
No
If yes, please explain
Can this child swim?
Yes
No
Child 2
Name of Child Enrolling
First Name
Last Name
Has this child taken a class from us before?
Yes
No
Does this child have any health concerns?
Yes
No
If yes, please explain
Does the child have any allergies?
Yes
No
If yes, please explain
Can this child swim?
Yes
No
Child 3
Age of Child
Name of Child Enrolling
First Name
Last Name
Age of Child
Has this child taken a class from us before?
Yes
No
Does this child have any health concerns?
Yes
No
If yes, please explain
Does the child have any allergies?
Yes
No
If yes, please explain
Can this child swim?
Yes
No
Should be Empty: