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Swimming Registration Form

Student's first name

Last name

Male Female Age

Course
Location: Brooklyn

Saturday Sunday Monday Wednesday Friday

Desired time
Session

2nd student's first name

Last name

Male Female Age

Course
Location: Brooklyn

Saturday Sunday Monday Wednesday Friday

Desired time
Session

3rd student's first name

Last name

Male Female Age

Course
Location: Brooklyn

Saturday Sunday Monday Wednesday Friday

Desired time
Session

Parent's name (required)

Street Address

City

State

Zip code

Parent's email (required)

Primary phone (required)

Work phone

Secondary phone

Emergency contact

Relationship

Phone

For your records. . .

Fees
See the Sessions page for the cost of the session you are signing up for.

All fees are payable to Camp Olympia 7304 5th Ave, # 271 Brooklyn, NY 11209
Note: please write the applicant's LAST, FIRST names on all material sent to us, including the check.