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Registration Form
This is to be filled out after scheduling with an instructor.

For your convenience, we have included the SouthWest Aquatics' Registration Form below.  After speaking to a representative and scheduling with one of our instructors, this form must be completed in order to participate in SouthWest Aquatics' Swim Programs and Activities.  Completing this paperwork ahead of time will ease transition on your first day of swimming at SouthWest Aquatics.

You may fill out and send the form in below, or fill it out on your first day at SouthWest Aquatics.


Document
You may also opt to download and fill out the form. Please bring it to SouthWest Aquatics or fax to 407-905-5268.
Registration Form
Father's Name
Father's Occupation
Mother's Name
Mother's Occupation
Address Line 1
Address Line 2
City
State
Zip Code
Home Phone() -
Mom's Cell() -
Dad's Cell() -
E-mail Address
Student's First Name
Student's Last Name
Student's Date of Birth
Student's Gender (M/F)
Primary Physician's Name
How did you hear about SouthWest Aquatics?
List any and all physicians, therapists, or other medical personnel this child has been seen by and the purpose for the visit excluding well check-ups as well as any physical exceptionalities
Have you scheduled already (Y or N)? If Yes, what instructor and time?
Thank you for your interest in SouthWest Aquatics!  We look forward to
working with you and your family!

SouthWest Aquatics
P: 407-905-0999
F: 407-905-5268
Info@SouthWestAquatics.com
205 Windermere Road
Winter Garden, FL 34787

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