2019 Youth Performance Camp Waitlist

Thank you for your interest in the 2019 Youth Performance Camp. Please fill in the information below to be added to the waiting list.

If a spot opens up for this year's camp, you will be contacted by one of our camp managers to collect payment. If a spot does not open up this year, your email will be put on the interest list for next's year camp.

Camper First Name *

Camper Middle Name

Camper Last Name *

Preferred Name (if different than above)

Mailing Address *

Address Line 2

City *

State *

Zip Code *

Country *

Cell Phone Number (camper must travel with a cell phone) *

Home Phone Number

Email Address (registration confirmation will be sent to this address) *

USA Swimming Club Affiliation * 🛈

USA Swimming Member ID (enter n/a if you do not have your number currently available, please note you must be an active member of USA Swimming to participate in camp) * 🛈

Date of Birth (Camper must be ages 12-17 at time of camp) * 🛈 +

Gender *

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone *

Emergency Contact Email Address

Tax ID Number 🛈

If registering on behalf of someone else, please enter YOUR contact information here:

First Name *

Last Name *

Phone Number *

Email Address *