Clone of Lake Highlands Memorial Day Lesson Registration Form

Safety Around Water FREE Swim Assessment and learning session. Park South (2500 Romine Ave., Dallas, TX, 75215)

Fill out the for registration
Parent's Name*

First NameMiddle NameLast Name
Parent Mobile Phone*
Format: (000) 000-0000.
Alt Phone Number*
Format: (000) 000-0000.
Parents Email *
example@example.com
How many children?*
Child's Name 1*

First NameLast Name
Child 2

First NameLast Name
Child 1 Birth Date*

MonthDayYear
Child 2 Birth Date

MonthDayYear
Pick a time for Saturday, May 24*

11:15 am11:30 am11:45 am12:00 pm12:15 pm12:30 pm12:45 pm
Should be Empty:

Safety Around Water FREE Swim Assessment and learning session. Park South (2500 Romine Ave., Dallas, TX, 75215)