Aquatics Camp Registration

Please complete the following form.

LAST NAME*

FIRST NAME*

ADDRESS*

CITY*

STATE, ZIP*

PHONE (DAY)*

PHONE (EVE)*

LOCAL RED CROSS CHAPTER

SIGN ME UP FOR

WSILGIRTELIFE GUARDINGFUNDAMENTALS OF CANOEING INLIFEGUARD MANAGEMENT TRAININSWIM TRAINING FOR CPR/FPR/AEDCPR/FPR/AED RECERTLIFEGUARD/WATERFRONT RECERT

Email Address*