Event Registration Form - Under Blue Waters printable pdf download

Event Registration Form

Today’s Date: _____________________

Participant Information:

Name: ____________________________________________________________________________________________

# Of Participants: ___________________________ DOB of participants: _____________________________________

Address: __________________________________________________________________________________________

Home Phone: ____________________________________ Cell Phone: ________________________________________

Email: ____________________________________________________________________________________________

Swimming Ability:

Unable

Poor

Average

Good

Very Good

Excellent

How did you hear about Under Blue Waters? _______________________________Referred by: ___________________

Event: ____________________________________________________________________________________________

Date of Event: ________________________________________ Time: _______________________________________

Location: _________________________________________________________________________________________

NOTES:__________________________________________________________________________________________

__________________________________________________________________________________________________

Please check form of Payment:

Mail in Check

Automatic charge of credit card or debt card provided

Call in Credit Card

Visa, Master Card, Discover and American Express.

Name on Card: ____________________________________________ Visa

DISCOVER

AMEX

Card Number __________-__________-_________-__________ Expiration Date: ____________ CV #_____________

Billing Address (If different then above address) __________________________________________________________

Deposit: _________________________________

Collect Balance: ___________________ Date: __________

Signature: ___________________________________________________Date:__________________________

Refund Policy: A participant can request a refund 3 days prior to the start of program/event. A refund will only be granted

if the request is made 3 days prior to the program/event, or the event is cancelled for any reason. A refund will be issued

if an injury occurs that does not allow the participant to continue in the program/event, or an emergency such as illness,

bereavement, etc. No other reasons constitute the issuance of a refund after the program/event has started. A $50

processing fee will be charged for all refunds that fall 3 days prior to program or event.

_______________________________________________________

________________________________

Name: (Name of parent or guardian if participant is under 18)

Date:

_______________________________________________________

Signature

Send completed Registration forms to Under Blue Waters, LLC via email at

or mail to

16244 S. Military Trail #310, Delray Beach, FL 33484. For further information, please call 561-715-0499.

Event Registration Form - Under Blue Waters

Related Articles

Related forms

Related Categories