Session/Time:
First name
Last name
Swimmer's Name:
Swimmer's
Date of Birth:
Gender:
Has your child taken lessons with CRAA before?
If so, when?
Last name
 First name
Parent Name:
Address 1:
Address 2:
City, St, Zip:
Home Phone:
 Cell Phone:
Work Phone:
 email address:
Comments:
This is a registration request only.  You are not registered until you receive an email confirming your
registration.   Please allow 2 to 3 business days to process your request.   If the swim clinic reaches
capacity prior to processing your request, we will notify you and refund your paypal payment.