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 join swim team.
2010-2011 Season
Eight Sessions- 10/5, 10/7, 10/12, 10/14, 10/19, 10/21, 10/26, 10/28
Childs Name: __________________________________ Birthdate: __________________ M/F_____
Address:________________________________________________________________________
City: ________________________________________

State:________

Zipcode: ____________

Mother:________________________ Phone Number: ________________ Cell Number: ______________

Father: ________________________ Phone Number: _________________ Cell Number: ______________
Family Contact Email Address: _____________________________________________________________
Medical Problems/Allergies: ________________________________________________________________
Emergency Contact: ____________________________ Emergency Phone:___________________
Family Physician: ______________________________ Physician Phone: ____________________

Fees
Program
Pre-Team

Amount Due

Discount

Amt. Paid

$110.00

$_________

$110.00

$_________

(Must be paid in full by 10/2/10)

Total Amount Due

** Make check payable to CORE Swimming

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