Tiny Bubbles Online Enrollment

* REQUIRED FIELDS                          You are currently ENROLLING (EARLY BIRD SPECIAL)

                     

*Parent/Caregiver Name  (First & Last Name)

 

 

*Mailing Address

 

 

*City

 

 

*Zip Code

 

 

Email Address

 

Please add my email address to your mailing list.

*Home Phone

 

         

Cell or Alternate Phone

 

 

 

Referral (If you were referred to us, please tell us by who)

 

 

How did you hear about us?

 

 

 

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*Child 1 (Student) Name  (First & Last Name)      

     

*Date of Birth

*Gender (M/F) Boy  Girl

*Prior Lessons  YES  No

If yes, where?    

 

Please select the Program for this child:

 

Requested Time Slot

*Remember time slots are not guaranteed until a Tiny Bubbles Swim Instructor has made

contact with you and Tiny Bubbles has received your Enrollment Fee.

Between   and   Am  Pm

 

Enroll Another Child

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*Child 2 (Student) Name  (First & Last Name)      

     

*Date of Birth

*Gender (M/F) Boy  Girl

*Prior Lessons  YES  No

If yes, where?    

 

Please select the Program for this child:

 

Requested Time Slot

*Remember time slots are not guaranteed until a Tiny Bubbles Swim Instructor has made

contact with you and Tiny Bubbles has received your Enrollment Fee.

Between   and   Am  Pm

 

Enroll Another Child

NEXT Step


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Child 3 (Student) Name  (First & Last Name)      

     

*Date of Birth

*Gender (M/F) Boy  Girl

*Prior Lessons  YES  No

If yes, where?    

 

Please select the Program for this child:

 

Requested Time Slot

*Remember time slots are not guaranteed until a Tiny Bubbles Swim Instructor has made

contact with you and Tiny Bubbles has received your Enrollment Fee.

Between   and   Am  Pm

 

Enroll Another Child

NEXT Step


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Child 4 (Student) Name  (First & Last Name)      

     

*Date of Birth

*Gender (M/F) Boy  Girl

*Prior Lessons  YES  No

If yes, where?    

 

Please select the Program for this child:

 

Requested Time Slot

*Remember time slots are not guaranteed until a Tiny Bubbles Swim Instructor has made

contact with you and Tiny Bubbles has received your Enrollment Fee.

Between   and   Am  Pm

 

NEXT Step


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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Agreement:

By clicking "Sign Me Up" you are stating that you hereby understand and agree that you are enrolling your child(ren) in a Tiny Bubbles swimming program and that no child is drown proof. You also understand that your child will not be enrolled into any Tiny Bubbles Program until your payment has been received and a Tiny Bubbles Instructor contacts you for scheduling confirmation. Furthermore, you understand and agree that if you elect to early withdraw your child(ren) from any Tiny Bubbles program, that your registration fee and swimming lesson fees (for services rendered) are non refundable.

 

 

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Valdosta, GA 31603