2022 Swim Lesson Registration (Members) – Cedarbrook Swim and Tennis Club

Parent/Guardian Name(Required)

First Last

Email(Required)

Phone(Required)

Name - Swimmer #1(Required)

First Last

Age of Swimmer #1(Required)

Swim Ability Group - Swimmer #1(Required)

Group 1: Pre-Beginner

Group 2: Beginner

Group 3: Advanced Beginner

Group 4: Pre-Swimmer

Group 5: Swimmer

Group 6: Stroke Development & Endurance

Please see the Group Ability Descriptions here: https://cedarbrookclub.org/lessons-programs/swim-lessons/

Product Name

Swimmer #1 Date(s)(Required)

Week I: June 20- June 23 (10:45-11:15)

Week I: June 20- June 23 (11:20-11:50)

Week II: June 27 – June 30 (10:45-11:15)

Week II: June 27 – June 30 (11:20-11:50)

Week III: July 5 - July 7 (10:45-11:15)

Week III: July 5 - July 7 (11:20-11:50)

Week IV: July 11 - July 14 (10:45-11:15)

Week IV: July 11 - July 14 (11:20-11:50)

If you have multiple swimmers, please add them on the following page!

Swim Lesson Subtotal

$0.00

Online Processing Fee

Price: $0.00

Total

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

2022 Swim Lessons - Members