Jane Whitt Swim School Summer 2012 Enrollment

Student Name:
Address:
City:                                                        State:                         Zip:
Daytime Phone:                                                   Evening Phone:
Birthdate:                                                              Email:                                       
Parent/Guardian Name:

Choose from the following:      (Mark all that apply)

          ___  Session I    JUNE 4 - 14, 2012 (MTWTh)    

                     __ Morning classes begin between 8am & 12:30 pm                                       
                     __ Afternoon classes begin between 12:15 and 5:30 pm
                     __ Evening classes begin 5:30 or later

___  Session II   JUNE 18 - 28, 2012  (MTWTh)

__ Morning classes begin between 10 am and 12:30 pm
__ Afternoon classes begin between 12:15 and 5:30 pm
__ Evening classes begin 5:30 or later

___ Session III      JULY 16 - 26, 2012  (MTWTH)

__ Morning classes begin between 8 am and 12:30 pm
__ Afternoon classes begin between 12:15 and 3:00 pm
__  Afternoon classes beginning after 3:00
__ Evening classes begin 5:30 or later

___ Learn to Swim          $85.00 by April 1st. . . $95.00 after April 1st    Available all sessions

___ Infant Swim              $85.00 by April 1st. . .  $95.00 after April 1st    Call for dates and times

Previous Experience:  __ No formal lessons.    __ Formal lessons - Level completed_____

Attach payment for full amount and mail to:

Jane Whitt Swim School                                                                        
7030 South Lewis, Suite J
Tulsa, OK 74136