Register form

Register For Swim Camp - Step1

*Parent's Name:

*Parent's Last Name:

*Parent's Email:

*Parent's Tel#:

*Address:

*City:

*State:

*Zipcode:

Register For Swim Camp - Step2

*Student Full Name:

*Parent/Guardian Full Name:

*Address:

*City:

*Zipcode:

*Cell Phone:

*Home Phone:

Work Phone:

*Email:

*Student Age:

*Student Date of Birth(mm/dd/yyyy):

*Choose # of weeks and 29dates :

Emergency contact and Phone Number:

Relationship:

T-shirt Size:

Couponcode:

$265 non-refundable deposit and $35 one time registration fee to be paid at the time of registration. Full payment is due by May 1st ,2011.
Make sure to reserve your spot. Number of seats is LIMITED!

Price per week: $439 per child. (Includes: swim practices, dry land trainings, all educational and fun activities, one unique trip, pick-ups and drop offs in Staten Island, lunch, snacks and T-Shirt).

 I've read and agree with the (Terms/Conditions) of Avantis Swimming Academy.