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2020 Summer Swim Lessons Registration
Please complete one for each student.
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Student Last Name *
Student First Name *
Student Birthdate *
MM
/
DD
/
YYYY
19-20 school attended
Grade during 19-20 school year *
School District You Reside In *
Parent Name *
Email
Parent/Guardian Phone Number can be reached at  during swim lesson *
Address *
City *
State *
Zip Code *
1st Choice                                                                                                                                                                   *
Child's Level  (if known)
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