Bixby High School

Swimming & Diving (C)

SWIM - Lessons - TWO Session Payment

Payment for TWO swim lesson sessions. Before submitting payment you must fill out the Registration Google Form and receive session confirmation from Coach David. The Registration Google Form is linked below in "Special Notes".

Camp Start Date:

June 2, 2025

Start Time:

9:00:00 AM

Camp End Date:

July 31, 2025

End Time:

1:15:00 PM

Date Details:

Session 1: June 2 - June 12, Session 2: June 16 - June 26, Session 3: July7 - July 17, Session 4: July 21 - July 31

Venue Name:

Swimming Pool

Venue Address:

601 S. Riverview, Bixby, OK 74008

Camp Cost:

$320.00

Questions:

David Zimmerman

dzimmerman@bixbyps.org

Special Notes:

Before submitting payment you must fill out the Registration Google Form and receive session confirmation from Coach David. https://forms.gle/PbkUqeGAe22UnK5s5

Medical Info:

By registering for this Camp, I agree to the following Waiver & Release of Liability: https://bixbyps.info/cewaiver

Download Brochure

SWIM - Lessons - TWO Session Payment

First Name *
Last Name *
Mobile *
Email *
Grade *
Birth Date *
Address *
City *
State *
Zip Code *
Medical Information *

List Medications/Medical Conditions here. If none, type N/A

Page 1 of 2

Next >>

Guardian First Name *
Guardian Last Name *
Guardian Cell Phone *
Guardian Email *
Alternate Guardian First Name
Alternate Guardian Last Name
Alternate Guardian Phone
Alternate Guardian Email
Medical Release Information
By registering for this Camp, I agree to the following Waiver & Release of Liability: https://bixbyps.info/cewaiver
Guardian Signature *

I, the parent/legal guardian, agree entirely to the Medical Release Information.: clear

Page 2 of 2

<< Previous

$320.00

Qty:

SWIM - Lessons - TWO Session Payment

CAMPER INFORMATION

PARENT/GUARDIAN INFORMATION