JTAC Swim Team
Swimmer Registration Form
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Parent's Information:
Primary Contact First Name *
Primary Contact Last Name *
Primary Contact Email *
Primary Contact Cell Phone *
Primary Contact Mailing Address *
Swimmer Pool Status / Fees per Swimmer
Clear selection
Swimmer Registration Information:
Families can register up to 4 swimmers on this form.  If you need to register more, contact jeffersonterraceswimteam@gmail.com 
Swimmer One
Swimmer One - First Name *
Swimmer One - Last Name *
Swimmer One - DOB / Birthdate *
MM/DD/YYYY
Swimmer One - Gender *
Swimmer One - T-Shirt Size *
Swimmer Two
Swimmer Two - First Name
Swimmer Two - Last Name
Swimmer Two - DOB / Birthdate
MM/DD/YYYY
Swimmer Two - Gender
Clear selection
Swimmer Two - T-Shirt Size
Clear selection
Swimmer Three
Swimmer Three - First Name
Swimmer Three - Last Name
Swimmer Three - DOB / Birthdate
MM/DD/YYYY
Swimmer Three - Gender
Clear selection
Swimmer Three - T-Shirt Size
Clear selection
Swimmer Four
Swimmer Four - First Name
Swimmer Four - Last Name
Swimmer Four - DOB / Birthdate
MM/DD/YYYY
Swimmer Four - Gender
Clear selection
Swimmer Four - T-Shirt Size
Clear selection
Submit
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