2015 Eastern States Swim Clinic
Registration Form

 

Information will be posted approximately 3 months prior to the event.

 

Name:_____________________________________________________________________________

Home Address:_____________________________________________________________________

City:_______________________   State:__________   Zip:__________

Phone (     ) _______________   E-mail Address:______________________

Club/School Affiliation: ___________________________________________

Type of Program:_College    _H.S.    _Age Group    Length of Season:______________________

Optional courses:

  Coach $: ______ 

  Swimmer (8 yrs & up) $: ______     
  Age: ______

MAIL YOUR REGISTRATION FORM TODAY!! DON’T MISS THIS CLINIC!!

Don’t forget your hotel reservation for special clinic rates.

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