Adult Lap Swim Registration Form Full Name(*) Invalid Input Date of Birth(*) Invalid Input Street Address(*) Invalid Input City/Town(*) Invalid Input Zip(*) Invalid Input Email Address(*) Invalid Input Phone Number(*) Invalid Input Are you a Member or a Non-Member?(*) MemberNon-Member Invalid Input I am comfortable in the water without assistance and am able to swim (with or without a noodle / kickboard) picking your feet up off the floor and propelling yourself through the water with your arm strokes and kicking(*) YesNo Invalid Input Submit
