SCAQ

Southern California Aquatic Masters

Trial Workout


Step 1 of 3

Registration Image

  • Biographical
  • Waiver
  • Payment
  • Receipt

Instructions Fill in this form and submit it.  After you submit it, you will be sent to a page that has all your information printed on a coupon.  Print this coupon and bring it with you to a workout for your free trial.

* Starred fields are required

Phones

Employer Information

(Name of the company)

Emergency Contact


Club Name
Club Name

Trial Workout Information

(mm/dd/yyyy)

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