Swimming Lessons Registration | FORT WORTH BOAT CLUB EAGLE MOUNTAIN LAKE

Participant Information

Swimmer's Name

First Last

Swimmer's Date of Birth*

Swimmer's Gender*

Last Name*

Father

Mother

Home Address*

Street Address Address Line 2 City State ZIP Code

Home Email Address*

Mother's Home Phone

Mother's Work Phone

Mother's Cell Phone

Father's Home Phone

Father's Work Phone

Father's Cell Phone

Emergency Contact*

First Last

Emergency Home Phone*

Emergency Cell Phone*

Please select the type of lesson and quantity you would like to register for and we'll be in touch to schedule the times.

Monthly Group Lessons

Price: $65.00 Quantity:

Fast Track (Two week Monday - Thursday)

Price: $120.00 Quantity:

Private Lesson 4-Pack

Price: $200.00 Quantity:

Total

$0.00