If you plan to pay for a class with cash, check, or money order, please print and fill out the information below. Make checks/money orders PAYABLE to URBAN SWIM CLE.  You can turn info, along with payment, into the front desk staff at the Cleveland Heights Recreation Center: Attention Eddis Singleton.

CLASS DETAILS

Session & Class:

Time/Slot:

ACCOUNT HOLDER INFO (Adult/Parent/Guardian)

Display First Name: 

Display Last Name: 

Login Email: 

Alternate Email 1:

Address: 

City: 

State: 

Zip: 

Phone: 

Alternate Phone:

MEMBER INFO (Student/participant)

Legal First Name:

Legal Last Name:

Preferred First Name:

Gender:

Birthday: