2016 BTC Summer GROUP Swim Lessons

Summer Address *

Phone 1 *

Area Code Phone Number
Phone 2

Area Code Phone Number
Child One
Name
Child One Age
Child One Sessions

July 5-14th ($120 Member / $180 Nonmember) July 18th-28th ($120 Member / $180 Nonmember)
Child One Swim Group
Child Two
Name
Child Two Age
Child Two Swim Group
Child Two Sessions

July 5-14th ($120 Member / $180 Nonmember) July 18th-28th ($120 Member / $180 Nonmember)
Running Total $
USD Total Due
Should be Empty: