Minnesota Masters

Registration

Step 1 of 4

"Team MN" for 2017 SCY Nationals

Biographical Waiver Fees Payment Receipt
* Starred fields are required
First Name *
Preferred (Nickname)
Middle Name
Last Name *
Sex *      Birth Date * (mm/dd/yyyy)
Phone
Home/Primary
Work/Secondary
Cell/Other
Email *
Street *
Street 2
City *
State*
ZIP *
2017 U.S. Masters Swimming (USMS) Club/Team Affiliation
Club/Team (Maximum of 5 alphanumeric characters)
Club/Team Name
Member Number use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS Number
(We will do our best to accommodate all requests)
(Please indicate if there is a Stroke you will NOT Swim on a Relay)
(If you want to be in contact with MN Nationals Coordinators)

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