Swimmer's Birthdate *

MM

DD

YYYY

Swimmer's Gender *

Male

Female

Swim Group you plan to join: *

Charger (High School Age - Advanced level swimmers, focused on top level competition)

Orange Group (Middle School Age - Approaching advanced level, learning to train and compete at the top level)

Blue Group (Advanced Age Groupers - Intro to training, refining of techniques, and increasing level of competition)

White Group (Novice Age Groupers - Learning all 4 strokes with an emphasis on technique and intro to competition)

Little Chargers (New To Swimming - Brand new swimmers learning efficient kick and technique)

Unsure

Parent/Guardian's Name *

First Name

Last Name

Parent/Guardian's Phone # *

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