West Shore Recreation Commission

 

LTS Registration

  


WSRC Home

 

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.
Faxes are no longer accepted.
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