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ALBRIGHT AQUATICS LEARN TO SWIM
ONLINE REGISTRATION

+++ Online registration deadline for Learn to Swim classes is one week prior to the start of the class +++
PLEASE NOTE THAT ONE FORM MUST BE COMPLETED FOR EACH CHILD

 
Child's Name:
Name:                      first                 middle               last
Age:
Parent/Guardian:
Name:                            first                middle              last
Day Phone:
Address: Evening Phone:
City:     State:    Zip: Membership:
E-mail:

L.T.S. (3yrs and up):

Session 1: member $50 / non-member: $55
Session 2: member $70 / non-member: $75 

LEVEL SESSION DAY/TIME

L.T.S. (Parent-Tot):

Session 1: member $35 / non-member $40
Session 2: member $50 / non-member $55

LEVEL SESSION DAY/TIME

PAYMENT INFORMATION:
Learn to Swim registrations MUST include payment.
Checks must be received PRIOR to the start of each session.
No refunds or credits will be honored.

I will be paying by: Check Credit Card


PAY BY CHECK:

Make checks payable to ALBRIGHT COLLEGE

Mail checks to:
Albright College
Ian Walsh
13th and Bern Streets
P.O. Box 15234
Reading, PA 19612-5234

Check Number:  Check Amount:


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