POOL PIRATES SWIM SCHOOL

WAITING LIST REGISTRATION

We apologize for not being able to accommodate your request for a time slot. 

Please use the form below to add your name to our waiting list.  We will notify you

should a spot become available.

Contact Information

Parent/Guardian Name

Street Address

City

State

Zip Code

Home Phone

E-mail Address

Swimmer Information

Swimmer 1 First Name

 Swimmer 1 Last Name

Swimmer 1 Middle Initial

Swimmer 1 Date of Birth

Sex

Male Female

 

Please list your preferred session and class time(s).

 

 

Swimmer 2 First Name

Swimmer 2 Last Name

Swimmer 2 Middle Initial

Swimmer 2 Date of Birth

Sex

Male Female

 

Please list your preferred session and class time(s).