Conejo Valley Multisport Masters

Online Registration

Step 1 of 3
Biographical Waiver Fees Payment
Instructions  To become a Conejo Valley Multisport Masters member, please complete this 2-step registration form.  On step 2 you will be asked for your credit card (Visa, MasterCard) information.  Once you complete step 2 and submit the form, you are immediately eligible to participate.
* Starred fields are required
First Name *
Preferred (Nickname)
Middle Name
Last Name *
Create Password
Sex *  
Birth Date * (mm/dd/yyyy)
Phones
Home *
Work
Cell *
Email *
Add Another Email Address
Street *
Street 2
City *
State *
ZIP *
2018 U.S. Masters Swimming (USMS) Club/Team Affiliation
Club/Team
Club/Team Name
Member Number use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS Number
USAT Number   Exp. Date
T-Shirt Size  (Adult)          
Employer (Name of the company)
Profession
Street   Street 2
City   State   ZIP
Emergency Contact (Parent, Spouse, etc)
Name *   Relation
Phone *
Name 2 *   Relation 2
Phone 2 *

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