People with Disabilities Registration

Name

Guardian's name if minor

Phone Number*

Phone

Email address*

Initials

Diagnosed Disability

When Diagnosed

Prognosis of Disability

Health Issues/Problems

Swimming History

Swimming Goals

Any other info for your instructor

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FIND YOUR FINS
Using swimming to reach challenged populations, adding a healthy dynamic to life.

We are a 501(c)(3) serving Tucson and surrounding areas, using swimming to reach challenged populations, adding a healthy dynamic to life.