Wisconsin Senior Olympics

Online Registration

Step 1 of 5
Biographical Waiver Sports Fees Payment Receipt
Please fill out the following information to begin the registration process.
* Starred fields are required
First Name *
Middle Name
Last Name *
Sex *      Birth Date * (mm/dd/yyyy)
Phone Home/Primary *   Work/Secondary
Cell/Other enter full number (555) 555-1212 x212
Street *
City *
If you will be competing in swimming events and you are already registered with US Masters Swimming:
2015 US Masters Swimming (USMS) Club Affiliation
Membership Number use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS Number
T-Shirt Size *  (Adult)          

Emergency Contact Name *

Emergency Phone *

Problem with this registration?

Powered by ClubAssistant.com   ©2003-2015   Page execution time: 187 ms