Cedardale Health & Fitness Jr Swim Registration Wtr 2021

Junior Swim Registration

Please complete the registration form below for your junior. One form must be completed for each junior registering. If you have an account with Cedardale we will process your registration with your current card on file. If you do not have an account with Cedardale we will contact you shortly by phone to gather your form of payment and complete your registration. For Swim Lessons Stacy Roberts will be contacting you to arrange lesson times.

Parent First Name

Parent Last Name

Address 1

City

State

Postal Code

Cell Phone

Email Address

Emergency Contact

Emergency Phone

Participant's First Name

Participant's Last Name

Date of Birth

Age

Program (please select one)

Red Cross Clinic - Tuesday 3:45 - 4:30 pm

Red Cross Clinic - Wednesday 3:45 - 4:30 pm

Swim Team 8 + Mon & Thurs 3:45 - 4:30 pm

Swim Team 12+ Mon & Thurs 3:45 - 4:30 pm

Swim Team Prep Clinic - Tuesday 4:30 - 4:15 pm

Swim Team Prep Clinic - Wednesday 4:30 - 5:15 pm

Swim Lessons - Arranged through Stacy Roberts

Swim Lesson Time Preference
Please indicate your preferred day(s) and time(s) base on available times listed under Swim Lessons

Session(s)
(select all that apply)

Session 3 Jan 4 - Feb 11 (6 wks)

Full payment is required at time of registration. We will contact you if a class is full and we can not accommodate your registration. If you are unable to make a clinic or team practice all make-ups will be held on December 17th. Cedardale reserves the right to use photos taken during lessons or programs for promotional purposes. If you wish that your child's photo not be used you must give a written request to the Aquatic Director. By submitting this registration you agree to the above terms.

* Bold Fields are Required - Required number fields will not accept 0's.