 |
| Name:* | |
| Phone:* | Please include your area code. |
| Email:* | Please be sure your email address is typed correctly. |
| Name of Club/Team: | |
| Address: | |
| City:* | |
| State:* | |
| Zip: | |
| You are a: | Swimmer Parent |
| Age: | |
| Are you the club's coach? | Yes No |
| *Denotes items that must be filled in to send this form. | |
What level(s) are the swimmers? And how many might attend? | < TR>
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| Age Group Swimmers: | 25 or fewer | 26 to 50 | 51 or more |
| Fitness Swimmers: | 25 or fewer | 26 to 50 | 51 or more |
| Master Swimmers: | 25 or fewer | 26 to 50 | 51 or more |
What month are you interested in having the clinic? Additional Comments: | |||
|
Tom Jager | The clinics | Calendar | More info | Tips Questions, comments or
problems about this website to jager50@juno.com |