Summer Swim League Registration

Swimmer Information

First Name

Last Name

Date of Birth

Gender

Address

City

State

ZIP Code

School Name

Parent/Guardian Information

Parent/Guardian Name

Additional Parent/Guardian Name

Phone Number

Email Address

Emergency Contact

Name

Phone Number

Relationship

Medical Information

List any allergies, conditions, or medications

Doctor's Name

Doctor's Phone

Swim Experience

Years of Experience

Preferred Events