Artistic Swimming New Figures Clinic Registration (Novice,Intermediate,12U)
Please complete the required fields and choose one clinic date.
Athlete and Guardian Information
Athlete Full Name
*
First Name
Last Name
Date of birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Name
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Clinic Details
Age Group / Level
*
Please Select
Novice
Intermediate
12U
How many years have you been doing artistic swimming?
*
Clinic Date (Choose the date that works best for you)
*
Saturday, October 10
Sunday, October 11
Emergency and Medical Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Medical Notes or Allergies
Choose the date that better feet your schedule
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Figures Clinic (Novice • Intermediate • 12U)
Full day Clinic (Lunch is not included)
$309.00
$
309.00
Quantity
1
2
3
4
5
6
7
8
9
10
Figures Clinic (Novice • Intermediate • 12U)
Full day Clinic (Lunch is not included)
$309.00
$
309.00
Quantity
1
2
3
4
5
6
7
8
9
10
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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