Swim School Sign Up (Full and Half month)

Swim School V2

Enrollment Information

Member Status?(Required)

Non-Member

Member

Enrolling for Full Month or Half Month?(Required)

Full Month

Half Month

Only select Half Month if you are starting class during the 3rd week of class of the month.

Parent Name(Required)

First Last

Parent Email(Required)

Parent Phone(Required)

Swimmer's Name(Required)

First Last

Date of Birth(Required)

Does your child have any health issues or allergies?(Required)

Yes

Please explain health issues or allergies here:

Member Pricing

Half Payment

Price:

Full Payment

Price:

Non-Member Pricing

Half Payment

Price:

Full Payment

Price:

Payment Information

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Order ID

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Name

First Last

Comments

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Swim School Sign Up (Full and Half month)

Swim School V2

Enrollment Information

Member Pricing

Non-Member Pricing

Payment Information

7-Day Trial with Tour