Mother's Home Phone: Cell Phone: Work Phone:

Father's Home Phone: Cell Phone: Work Phone :

Mother's E-Mail:

Father's E-Mail:

1. Children you wish to drop of

2. Enter the drop off and the pick up times

Drop Off Time: Pick Up Time:

3. Choose a price Plan

10/Hour
40 Hour Whenever Pass ($239)
20 Hour Whenever Pass ($139)
16 Hour Whenever Pass ($127)
I already have a 'Whenever' Pass
* ($1/HR EACH ADDITIONAL SIBLING)

4. Calculate Total Tuition:

Subtotal: Additional Children at $1/Hour. Total Amount:

If you have already paid the annual registration fee and/or you are participating in a current discount program, your price will be adjusted in our office before processing.
To adjust the selected classes, go back in your browser to the appropriate schedule page.

How Do You Wish to Pay?

(*Security Code: The last three digits following the account number
in the signature line on the back of the card)

Check - If you register online and prefer to pay by check,
you may not register on-line.

Please print out the form and mail along with your payment.
Mail to:
SwimKids USA
9319 Huntington Park Way
Tampa, Florida 33647

Enter Any Comments You Would Like to Make

By submitting this form, I certify that I have read, met, and agree to SwimKids USA's Policies and Procedures

Click on the "Submit Information" button to forward your request.