SUPER SWIMS

Spring 2026 Registration

Parent First Name

Parent Last Name

Student A First Name

Student A Last Name

Student A Birthday * required

Email

Student B First Name

Student B Last Name

Student B Birthday

Phone

Student C First Name

Student C Last Name

Student C Birthday

Street Address

City

Postal Code

Proud Lifesaving Society Affiliate

OAP Eligible - Occupational Therapist Supervised Program Available

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