Port City Diving 12
January 4 - April 28
Port City Diving Spring 2012
Team Registration Form
Spring Fees. 2 payments Semester pay up
1 day a week $200 (2x$100) $190
2 days $275 (2x$137.5) $245
3 days $336 (2x$168) $300
4 days $384 (2x$192) $345 NEW Divers: add $14 for AAU insurance
Name of Diver
Mailing Address – including zip
Parent(s) Guardian(s) Date of Birth
Level Signing up for (B,S,G,N) Cell Phone (In case of changes)
E-mail
Monday Wednesday Thursday Friday (gym) Saturday (1/2)
Fees Paid
Check Number
Emergency contact information
Emergency contact 1
Emergency contact 2