Neshaminy CORE Swimming

Pre-Team
Registration & Fee Schedule
Brian Suter - Head Coach
neshswim@yahoo.com
Learn basics of competitive swimming in a fun, lesson format. Preparation to jo
in swim team.
2011-2012 Season
Eight Sessions

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Child s Name: __________________________________

M/F_____

Birthdate: ______________

Address:________________________________________________________________________
City: ________________________________________
__________

State:________

Zipcode: __

Mother:________________________ Phone Number: ________________ Cell Number: ____

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Father: ________________________ Phone Number: _________________ Cell Number: __
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Family Contact Email Address: __________________________________________________
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Medical Problems/Allergies: ____________________________________________________
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Emergency Contact: ____________________________ Emergency Phone:_______________
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Family Physician: ______________________________ Physician Phone: ______________
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Fees
Program

Amount Due

Discount

Amt.

Paid
Pre-Team
$_________
(Must be paid in full by 10/2/10)

$110.00

Total Amount Due

$_________

$110.00

** Make check payable to CORE Swimming

*** No refunds will be given after October 15th. Refunds are subject to a $50 p
rocessing fee.