Peluso Open Water Masters

Online Registration

Step 1 of 3
Biographical Waiver Payment Receipt
Instructions  To become a Peluso Open Water Masters member, please complete this 2-step registration form.  On step 2 you will be asked for your credit card (Visa, MasterCard, Discover) 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)
Phone Home/Primary   Work/Secondary
Cell/Other enter full number (555) 555-1212 x212
Email *
Street
Street 2
City
State
ZIP
2015 US Masters Swimming (USMS) Club/Team Affiliation
Club/Team (Maximum of 5 alphanumeric characters)
Club/Team Name
Membership Number use all 10 digits, i.e. 3348-0000A
Register for USMS | Retrieve USMS Number

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