Session:
(choose one of the available time slots for the Black swim group)
Parent Name:
(first and last)
Address 1:
Address 2:
City, St, Zip:
Home Phone:
 Cell Phone:
Work Phone:
 email address:
Swimmer's Name:
(first and last)
Swimmer's Age:
Gender:
Swimmer's
Date of Birth:
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 your Session choice   
reaches capacity prior to processing your request you will be contacted to discuss other possible time
slots.  If we do not have a time slot open that is satisfactory to you, we will refund your paypal payment.