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PMPA
Home
Swimming Pool
Pool Rules
Refreshment Stand
Swimming Lessons
Jittery Joints and Lap Swimming
Membership
Employment
Pavilions
Special Events
Easter Egg Hunt
Fun Day
Veterans Appreciation Day
Christmas in July
Old Timer's Day
Raffle At Palmerton Festival
75th Anniversary
About
Photos
Board of Directors
Support
Contact Us
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
Home
Swimming Pool
Pool Rules
Refreshment Stand
Swimming Lessons
Jittery Joints and Lap Swimming
Membership
Employment
Pavilions
Special Events
Easter Egg Hunt
Fun Day
Veterans Appreciation Day
Christmas in July
Old Timer's Day
Raffle At Palmerton Festival
75th Anniversary
About
Photos
Board of Directors
Support
Contact Us