Home
Staff
Schedule
Programs
Gallery
Registration
Learn To Swim
Facebook
Thank you for registering with us.
1
1
http://swimharper.club/wp-content/plugins/nex-forms-express-wp-form-builder
false
message
http://swimharper.club/wp-admin/admin-ajax.php
http://swimharper.club/new-bronze
yes
1
fadeIn
fadeOut
Guppies Registration
Monday - Thursday
May 16 - June 8
7:00-7:30pm
$130
Parent or Legal Guardian
*Name
*Email
*Phone Number
*Street
*City
*State
*Zip Code
Back
Next
Contact Karolina Papiez at (269) 986-1760 if you have questions about payments.
Swimmer(s)
Number of Swimmers
1
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
*Program
New Bronze
Back
Next
Membership Agreement
I, for myself, my heirs, personal representatives or assigns, do herby waive, release, and discharge club coaches and assistants of Harper Creek swim club, its directors, officers, employees, and agents from liability for any and all claims and damages, including those caused by the negligence of HCSC, resulting in personal injury, accidents or illnesses, and property loss arising from, but not limited to, participation in activities, swim team, classes, observation, and use of facilities, premises or equipment. I agree that this Waiver and Release is also signed by me on behalf of all minor children of which I am the parent or guardian, and on behalf of my guests or anyone gaining entrance to the pool through the use of my membership.
I Agree
Registration Total: $
0
Payment will be remitted to Jena Wager.
Back
Submit
