SWIMMING & CULTURE – MASTERS – LEONIDAS: REGISTRATION FORM

Name

First

Last

Email

Phone Number (Please add WhatsApp number if applicable)

Gender

Date of Birth MM/DD/YYYY

Country

City

Address

Zip Code

Swimming Level

Which week are you interested in attending?

Package Price per Person (Breakfast and Dinner included)

Are any family members joining you during this trip?

If Yes, how many people are joining you?

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

MM/DD/YYYY Date Date

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

Name

First

Last

Date of Birth MM/DD/YYYY

Relationship

Please state any dietary restrictions, medical issues, disabilities or anything else we should be aware of:

Hellenic Aquatics