Susquehanna Spring 2013 Clinic Registration
(Training and Stroke Clinics)

What: This is a training clinic for competitive swimmers 12 years of age and up while the stroke clinic is for ages 9-11 (from any team) who desire to prepare for their summer season; it will include dry-land, skill instruction and swim practices at the Susquehanna University pool. 

Age:

Sex:

City:

State:

Zip Code:

E-mail Address:

Phone Number:

Number of Years Swimming:

Which Clinic:

Any Medical Concerns that the Instructors Need to Be Made Aware of (i.e. asthma, high blood pressure)? If yes, please specify:

Do you release Susquehanna of any injury liability?: If yes, please initial:

It is recommended that your primary care physician reviews your health before you begin any exercise program. Please acknowledge that you are in good health by initialing:

Thank you!