Hammerhead Aquatics - Online Registration

Instructions To become a Hammerhead member, complete this registration. Once you complete the registration, you are immediately eligible to participate.

* Starred fields are required

First Name *

Preferred (Nickname)

Middle Name

Last Name *

Create Password

Sex *

Female Male

Birth Date *

Phones

Home *

Work

Cell

Email *

Country *

Street *

Street 2

City *

State *

ZIP Code *

2023 U.S. Masters Swimming (USMS)

USMS Club

Member Number

Use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS Number

T-Shirt Size *

[Adult]

XXL

Employer Information

Employer

(Name of the company)

Profession

Street *

Street 2

City *

State *

ZIP Code *

Emergency Contact

Name *

Relation

Phone *

Name 2 *

Relation 2

Phone 2 *

List any medications and dosages that the swimmer is currently taking:

List any other medical information:

Medical Insurance Provider:

Policy Number:

Primary Care Physician (Name / Phone):