Gold Medal Swim Club

Parent/Guardian Information

First Name*

Last Name*

Phone*

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Email Address*

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Street Address*

Please include a unit number, if applicable.

City*

State*

Zip Code*

Student Information

First Name*

Last Name*

Preferred Name (optional)

Gender*

Date of Birth*

Team Selection*

T-Shirt Size*

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HIDDEN Has your swimmer or other family member, currently or previously, enrolled in lessons at the Gold Medal Swim School?

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HIDDEN Is your swimmer currently a registered USA Swimming club member?

Allergies the GMSC staff should be aware of? (i.e. food, seasonal, medications, etc?)*

Medical condition(s)/medication(s) (i.e. inhaler) the GMSC staff should be aware of?*

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Would you like to add another student?

Yes

Student Information

First Name*

Last Name*

Preferred Name (optional)

Gender*

Date of Birth*

Team Selection*

T-Shirt Size*

This field is hidden when viewing the form

HIDDEN Has your swimmer or other family member, currently or previously, enrolled in lessons at the Gold Medal Swim School?

This field is hidden when viewing the form

HIDDEN Is your swimmer currently a registered USA Swimming club member?

Allergies the GMSC staff should be aware of? (i.e. food, seasonal, medications, etc?)*

Medical condition(s)/medication(s) (i.e. inhaler) the GMSC staff should be aware of?*

This field is hidden when viewing the form

Would you like to add another student?

Yes

Student Information

First Name*

Last Name*

Preferred Name (optional)

Gender*

Date of Birth*

Team Selection*

T-Shirt Size*

This field is hidden when viewing the form

HIDDEN Has your swimmer or other family member, currently or previously, enrolled in lessons at the Gold Medal Swim School?

This field is hidden when viewing the form

HIDDEN Is your swimmer currently a registered USA Swimming club member?

Allergies the GMSC staff should be aware of? (i.e. food, seasonal, medications, etc?)*

Medical condition(s)/medication(s) (i.e. inhaler) the GMSC staff should be aware of?*

Student Information

First Name*

Last Name*

Preferred Name (optional)

Gender*

Date of Birth*

Team Selection*

T-Shirt Size*

Allergies the GMSC staff should be aware of? (i.e. food, seasonal, medications, etc?)*

Medical condition(s)/medication(s) (i.e. inhaler) the GMSC staff should be aware of?*

We’re Making a Splash in Surprise, AZ – Coming Soon!

GMSC Registration

WELCOME TO THE GOLD MEDAL SWIM CLUB