Cottonwoods Pool
Summer Registration
Name:
_____________________ Age: ______ Birthday: _______________
Level:
__________
Name:
_____________________ Age: ______ Birthday: _______________
Level:
_________________
Name:
_____________________ Age: ______
Birthday: _______________
Level:
_____________________
Address: ญญญญ__________________________ Phone: _________________
___________________________
Cell: ____________________
___________________________
Work: __________________
E-Mail:
_________________________
Parents
name: ญญ______________________________
Session/
Dates: ______________________________
Time:
____________________________________
Deposit:
_________________ Payment:
____________________
Additional information: A $50 deposit
will hold your spot. The balance is due
the 1st day of class.
_____________________________________________________________________________________________________________________________________________________________
Checks made to: Cottonwoods Pool LLC 678-429-8042 e-mail: cottonwoodspool@gmail.com Web site: cottonwoodspool.com
Signed:
____________________________________________