Professional Documents
Culture Documents
Family Dentist_______________________
Dentist’s Phone#_____________________
Family Insurance______________________
If there are any medical or emotional concerns please place on back. All information will be kept
confidential.
Please fill in application putting your oldest child’s information first, your youngest child’s last.
All lessons are subject to change due to weather and pool conditions. Every effort will be
made to make up lessons, but due to certain time constraints this is not always possible.