Medina

Foss Swim School Registration Form Contact Information Enter your information Parent's Name Address (address con't) City State Zip Home Phone Alt. Phone Email How did you hear about us? Select One FM 107.1 WCCO Channel 4 News Phone Book/Web Listing Mailing from FOSS Friend/Family Recommendation Advertisement Other   History Your history with Foss Swim School® Family Status Select One Past Family (Not Swimming in Spring 2007) New Family (Add $35 One Time Fee) Registration Code NONE CS1 CS2 CS3 CS4 CS5 CS6 CS7 CS8 DB1 DB2 DB3 DB4 DB5 DB6 DB7 DB8 LP1 LP2 LP3 LP4 LP5 LP6 LP7 LPA1 LPA2 LPA3 LPA4 LPA5 LPA6 LPA7 LPC1 LPC2 LPC3 LPC4 LPC5 LPC6 LPC7 EB (found within brochure mailing label only)   Child Information First Child Name Age Birthday MM/DD/YYYY Sex Male Female Class Level Little 1 Little 2 Little 3 Little 4 Middle 1 Middle 2 Middle 3 Middle 4 Big 1 Big 2 Big 3 SW2 SW3 SW4 SW5 Preferred Session A B C D E Tuesday PM SWIMTEAM Preferred Time (HH:MM)    AM PM 2nd Choice Session A B C D E Tuesday PM SWIMTEAM 2nd Choice Time (HH:MM)    AM PM   Child Information Second Child Name Age Birthday MM/DD/YYYY Sex Male   Female Class Level Little 1 Little 2 Little 3 Little 4 Middle 1 Middle 2 Middle 3 Middle 4 Big 1 Big 2 Big 3 9 & Over 8 & Under Preferred Session A B C D E Tuesday PM SWIMTEAM Preferred Time (HH:MM)    AM PM 2nd Choice Session A B C D E Tuesday PM SWIMTEAM 2nd Choice Time (HH:MM)    AM PM   Child Information Third Child Name Age Birthday MM/DD/YYYY Sex Male Female Class Level Little 1 Little 2 Little 3 Little 4 Middle 1 Middle 2 Middle 3 Middle 4 Big 1 Big 2 Big 3 9 & Over 8 & Under Preferred Session A B C D E Tuesday PM SWIMTEAM Preferred Time (HH:MM)    AM PM 2nd Choice Session A B C D E Tuesday PM SWIMTEAM 2nd Choice Time (HH:MM)    AM PM   Message Special Instructions & Requests Enter Message   Member Member Information Member Number