West Shore Recreation Commission
 

 

LTS Registration

  

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TO:                 West Shore Rec Commission
FROM:            
DATE:           

Type in information, then print and mail to West Shore Rec.
Please note that this activity fills quickly and registration by telephone is the best method.
You will receive a confirmation if an e-mail address is provided!

Learn To Swim Registration Form

Name      
Birthdate 
Level           
Session #        Second Choice, if desired: 
Time               Second Choice, if desired:  
Street Address    
City        
Zip Code 
Township or Borough  
Home Phone    
Parent Name    
Daytime Phone    or  Cell Phone  
Credit Card #   
Expiration Date 
E-mail Address 

Adult Volunteer?  Choose:  no thanks  clerical aide  water aide

 West Shore Recreation Commission
704 Lisburn Road, Suite101
Camp Hill, PA  17011
717-920-9515