Swim Team Registration Request Form

Participant Information

Swimmers Name*

First Last

Date of Birth*

Age

Gender:*

Swimmer is a:*

Parent is a:*

Session Dates

Select One

Contact Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact Person*

Emergency Contact Phone*

Comments

Enrollment Procedures

Submitting this form is confirming your request for the swimmers enrollment into lessons and all indicated session dates.
Request forms will be sorted by when recieved as well as by Member and Non-member.

Payment Procedures

Cancellation and Refunds

Cancellation or un-enrollment from future sessions or classes must be received by email.
Once session started there will be no refunds or make-up classes.

I understand that this is a registration request form and my enrollment is not complete.

I accept full responsibility for my child’s use of any and all apparatus, appliances or facility privilege or service whatsoever, owned and operated by Columbia Athletic Clubs at their own risk and shall hold the Club, its shareholders, directors, officers, employees, representatives, and agents harmless from any and all loss, claim, injury damage or liability sustained or incurred by my child resulting therefrom.

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Phone

This field is for validation purposes and should be left unchanged.