Hoover Swim Lesson Registration

BLAST Swim Lesson Registration

SESSION 3: ALL CLASSES ARE NOW FULL!

Click here to view the Swim Lesson flyer.

Sess Mondays/Wednesdays October 1-17 Registration deadline September 21

                                                                    Mondays/Wednesdays   *October 22-November 12      Registration deadline October 12
                                                                     Mondays/Wednesdays   January 14-30                       Registration deadline January 4
                                                                                   *No class on Wednesday October 31^st.

$30.00 if registered by the above deadlines

$35.00 if registering after the above deadline, or if registering on the first day of lessons

Swimmer's Last Name Swimmer's First Name Swimmer's Middle Initial

Birthday Date Home Phone

Street Address City State Zip

Mother's Name Father's Name

Medical conditions instructors should be aware of:

Additional comments such as:

Session Group Placement

***SESSION 3: January 14-January 30th, ALL GROUPS ARE FULL! SORRY FOR ANY INCONVENIENCE.***
*If you unsure of group placement, email Carissa at carissarabel@hotmail.com or go to the "Programs Offered" page of the website to view class descriptions.

Do you have daily access to internet and email? yes no

I have filled this form out to the best of my ability and knowledge, and accept full financial responsibility for this swimmer. yes no

Payment will be due on the first night of lessons. Make all checks payable to: BLAST