UCLA Bruin Swim Club

UCLA Bruin Swim Club

Information Request


Step 1 of 3

  • Biographical
  • Waiver
  • Payment
  • Notes
  • Receipt

* Starred fields are required

Swimmer Information

Phones

(Maximum of 5 alphanumeric characters)
(14 characters formatted MMDDYYFFFMLLLL)

Emergency Contact


Parents must list themselves in addition to any other authorized individual.
Swim Release Authorization: Children 12 years of age and older. I request UCLA Recreation to allow my child to release themselves at the end of practice.
Enter a whole number.