Swimming Registration

To register for swimming lessons:

Complete the form below
PLEASE fill in all applicable fields.
Please review the Swim Schedules prior to filling in this form to get day, class, time and fees.
Submit your registration, Please allow 24 hours to process registration
You will be contacted only if your class is NOT available. Otherwise, feel free to contact SeaVentures to verify your class and time.

Sorry... We can't send an email confirmation once you have registered, but you are more than welcome to call us the next day to make sure we got your registration.

If you are new to our program, please come by and say hello and take a tour of our facility. We look forward to seeing you at your lesson!

Don't forget to check out our web site for other exciting activities at SeaVentures like Birthday Parties, Kids Night Out and SCUBA lessons!.

Please provide the following information: All fields in yellow are required.

First Name
Last Name

Student's Name
Student Age

Street Address Student Birth Date

City
Zip

Cell Phone
Work Phone

Home Phone E-mail

Does your child have asthma? No Yes
If yes, explain

Please provide the following swim session information:

Session Registration Fee = $30.00

Class/Level

Class Day

Class Time

Fee

Session

Class/Level

Class Day

Class Time

Fee

Session

Class/Level

Class Day

Class Time

Fee

Session

Class/Level

Class Day

Class Time

Fee

Were you referred?
If so...by whom??
YES NO

Comments Enter any additional information here.

Please provide the following billing information. Please be sure your fee total is correct, including registration fees.

BILLING

Credit Card

Acct. Number

Expires

Total $
Please add registration fee of $30.00 if not yet paid for this year.

You must agree to the SeaVentures Terms and Conditions as stated in the Participation and Release Agreement. By Pressing the Submit button below, you state you have read and agree with the terms as stated in the agreement, and you authorize SeaVentures to charge your credit card for the correct amount for the lesson(s) for which you would like to register.

If you have read and agree to the terms in the Participation and Release Agreement, please type the word yes here: (lower case only)

NOTE: If your submission fails, please use the BACK button on your browser to return to this page! This will save all of your information so you do not have to re-type.

*First Name*		*Last Name*
*Student's Name*		*Student Age*
*Street Address*		*Student Birth Date*
*City*		*Zip*
*Cell Phone*		*Work Phone*
*Home Phone*		*E-mail*

Does your child have asthma? No Yes		If yes, explain

*Session*		Registration Fee = $30.00
*Class/Level*
*Class Day*
*Class Time*
Fee

*Session*
*Class/Level*
*Class Day*
*Class Time*
Fee

*Session*
*Class/Level*
*Class Day*
*Class Time*
Fee

*Session*
*Class/Level*
*Class Day*
*Class Time*
Fee
Were you referred? If so...by whom??	YES NO
*Comments*	Enter any additional information here.

BILLING
*Credit Card*
*Acct. Number*
*Expires*
*Total $*	Please add registration fee of $30.00 if not yet paid for this year.

Copyright © 2006 SeaVentures, Inc. All rights reserved. Revised: 11/07/08

Copyright © 2006 SeaVentures, Inc. All rights reserved.
Revised: 11/07/08