• Miami Valley Aquatic Club
    MAKOs
    Fall - Winter 2011-12 Registration
  • First Child's Info.
  • Full Name*

  • Preferred Name

  • Group*

  • Is this their first season with Makos?*

  • Gender*

  • Age *

  • Date of Birth*

    MM/DD/YYYY
  • Medical Problems/Allergies

    Needed for Medical Release Form
  •  
  • 2nd Child's Info.
  • Full Name

  • Preferred Name

  • Group

  • Is this their first season with Makos?

  • Gender

  • Age

  • Date of Birth

    MM/DD/YYYY
  • Medical Problems/Allergies

    Needed for Medical Release Form