Professional Artistic Swimming Club Membership Form

Artistic Swimming Club Membership Form

Please complete the form below if you are interested in enrolling your child in our Artistic Swimming Program this information will help us better understand the athlete’s background and place them in the most appropriate training group.Our team will review your submission and contact you with the next steps.
Parent/Guardian Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child's Full Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Is this the athlete’s first time trying artistic swimming?

Other
Is the athlete currently a registered member of USA Artistic Swimming?
Which program are you interested in?
Does the athlete have previous experience in swimming?
Does the athlete have previous experience in artistic swimming?Please briefly describe your level of experience in artistic swimming:
If the athlete has trained before, which club are they currently coming from?
Does the athlete have any medical conditions, allergies, or health concerns we should be aware of?
What are the athlete’s goals in artistic swimming?
Which days and times would be preferred for the artistic swimming classes?
Emergency Contact Name and Phone
How did you hear about us?
Where did you hear about us?

Other
Should be Empty: