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*Participant Name *Parent Name *Mailing Address *Desired Lessons *Desired Lesson Month *Desired Lesson Location Please Select One East South (Anchorage) Valley *Confirm Lesson Location Please Select One East South (Anchorage) Valley *Type of Lesson Desired Please Select One Infants and Toddlers PreLevel 1 PreLevel 2 PreLevel 3 Level 1 Level 2 Level 3 Level 4 Parent/Toddler Swim Team Private Semi-private *Phone     *Date *Email Work Phone        *Member/Scan Number I am a The Alaska Club member! I am a Membership Plus member! Class charges Charge the cost of my desired class to my account for this month. Charge the cost of my class to monthly until I cancel. All payment required on or before the 1st day of classes. Download Fairbanks information here.