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Masters Registration Form
Please fill this out as registration to Boonville Dolphins Swim Masters program
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* Indicates required question
Email
*
Your email
Masters ID (issued by
usms.org
)
*
Your answer
Last Name
*
Your answer
First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Sex
*
Female
Male
Prefer not to say
Practice Location
Boonville
Tecumseh
Southridge
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Mailing Address
*
Your answer
Phone Number
*
Your answer
I agree to being billed $25 per month to cover lifeguard expense and team administrative fees
*
Agree
Required
I understand I must retain registration with
usms.org
in order to participate in this program.
*
Agree
Required
Send me a copy of my responses.
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