Group Child Pass Registration

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PMPA

Home
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Employment
Pavilions
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Board of Directors
Support
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GROUP CHILD MEMBERSHIP REGISTRATION

Group Child pass - Register online here

* Indicates required field

Last Name (person receiving pass) *

Address (person receiving pass) *

Line 1

Line 2

City

State

Zip Code

Country

Phone # (person receiving pass) *

Email (person receiving pass) *

Child 1 for pass *

First

Last

Birthday of Child 1 *

Swimming Lessons Child 1? *

Yes ($10 extra) No

Child 2 for pass *

First

Last

Birthday of Child 2 *

Swimming Lessons Child 2? *

Yes ($10 extra) No

Child 3 for pass *

First

Last

Birthday of Child 3 *

Swimming Lessons Child 3? *

Yes ($10 extra) No

Child 4 for pass *

First

Last

Birthday of Child 4 *

Swimming Lessons Child 4? *

Yes ($10 extra) No

Child 5 for pass *

First

Last

Birthday of Child 5 *

Swimming Lessons Child 4 *

Yes ($10 extra) No

Child 6 for pass *

First

Last

Birthday of Child 6 *

Swimming Lessons Child 6? *

Yes ($10 extra) No

Child 7 for pass *

First

Last

Birthday of Child 7 *

Swimming Lessons Child 7? *

Yes ($10 extra) No

Comment *

Name of person purchasing pass (if different than above) *

First

Last

Email (if different than above) *

Phone # (if different than above) *

By pushing submit, you agree to make your payment upon receipt of invoice within 24-48 hours. Otherwise, please print and mail the application with your payment.

Submit & Next

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Home
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Employment
Pavilions
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Board of Directors
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