Swimmmer Name *

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Last Name

Swimmer Date of Birth *

MM

DD

YYYY

Caregiver Name

(if swimmer is under 18)

First Name

Last Name

Contact Number

(###)

###

####

I would like to join Swimming New Zealand and Swimming Canterbury West Coast as a Recreational Swimmer for FREE (Recommended)

Agree

Swimmmer Name *

First Name

Last Name

Swimmer Date of Birth *

MM

DD

YYYY

Caregiver Name

(if swimmer is under 18)

First Name

Last Name

Contact Number

(###)

###

####

I would like to join Swimming New Zealand as a Recreational Swimmer for FREE (Recommended)

Agree

Swimmmer Name *

First Name

Last Name

Swimmer Date of Birth *

MM

DD

YYYY

Caregiver Name

(if swimmer is under 18)

First Name

Last Name

Contact Number

(###)

###

####

I would like to join Swimming New Zealand and Swimming Canterbury West Coast as a Recreational Swimmer for FREE (Recommended)

Agree