Required fields are marked with asterisks (*)

Aquafit

*If you have weights we ask you to please bring them to aquafit class.

June schedule:

Cardinal Pool:

Participant's Information

First and last name

Date of Birth

Email address

Cell Phone Number

Home Phone Number

Address

Which pool do you attend?

Cardinal Pool

Johnstown Pool

Both

Do you have any medical conditions that you know about?

Are you taking any medications? If so, Please provide them below.

Have you had any major medical issues in the last 3 years? Example, stroke, heart attack, etc.

Do you have any allergies? If so, please list.

Name First and Last

Cell Phone Number

Home Phone Number

Relationship to Participant's