The Fast Lane Swim Camp Online Registration Form
Swimmer #1
First Name
Last Name
Birth Date
Gender
Age
Please Choose Adult T-shirt Size
Swimmer #2
First Name
Last Name
Birth Date
Gender
Age
Please Choose Adult T-shirt Size
Address
City
State
Zip Code
Home Phone
Cell Phone
Emergency Contact
Emergency Phone
e-mail Address
If you have a certificate code, please enter it here:
Please Choose The Location and/or Session
You Are Interested In
Week #2 at Berea High School and Week #3 at Notre Dame College are Full
The Fast Lane Swim Camp
www.fastlaneswimming.net
335 Rowan Drive, Berea, Ohio  44017  
440-826-0579 ~ coachmike@fastlaneswimming.net