Alpena Plaza Pool Swim Class Registration Form

By registering for Alpena County Swim Lessons I have been provided the on-line Patron Agreement and agree to follow all policies and procedures. I understand that failure to do so can result in removal from the facility.
You may also register for the Splash Bus program using this form. Please be sure to include your address when you register for the Splash Bus. Click on Splash Bus for further information.
Classes for Fall are: Session I: Wednesday September 15 - October 13 Session II: Wednesday October 20 - November 17 Session III: Wednesday November 24 - December 22

^*Parent Name
^*Telephone
^*Address
^*Email
^*I have read the the on-line patron agreement and agree to abide by the rules.
Classes are one week long, meeting five times weekly. The price is $45. Non-pass holders pay an annual registration fee of $25.00.
In the following spaces please indicate the number of children to be registered and then list the names
Number Children Registering

^*First Child's Name
	Child's Age
	Swimming Level (Explanation)
	Lesson Date
Second Child
	Child's Age
	Swimming Level (Explanation)
	Lesson Date
Third Child
	Child's Age
	Swimming Level (Explanation)
	Lesson Date
Fourth Child
	Child's Age
	Swimming Level (Explanation)
	Lesson Date
Use the space below for special information for the Plaza Pool Staff.

^* Required Field