Welcome to
The Derby Swim Club

The Derby Swim Club provides an opportunity for children of the Derby area community to participate in a competitive swimming program during the summer months. Swim practice with a coach is provided during the winter months.

Register and Pay

Online Registration and Payment is provided for your convenience. After you complete this registration form, you will be taken to another page where you may pay with one of the following OR a PayPal account:

Our secure online payment option is processed through PayPal. You do not need a PayPal account. Please read or print [complete instructions].

SUMMER SWIM Registration Form 2008
After completing this form, you will be taken to an online payment page
Registration is $100 for first swimmer, $75 for other family swimmers, Insurance is $27

  Swimmer #1 Swimmer #2 Swimmer #3
Swimmers Name
Swimmers Birthday
Swimmer is Male Female Male Female Male Female
Parents Email
 
Your Name
*
Other parents name
Street Address
City, State, Zip
Home Phone
*
Other Phone
I give permission for my children's photos to be posted on the web site: (initial if yes)
If you choose No, please notify a board member and the coaches.
Parental involvement is required. Please check ALL volunteer position(s) you will be involved with for the summer swim meet session:
Starter or Recall Starter must complete the certification clinic and required USA Swimming exams Stroke/Turn Judge must complete the certification clinic and required USA Swimming exams Clerk of the course
Timer Head Timer Place Judge
Swim4FUNdz planning team Runner Ribbons
Computer team Announcer Volunteer Coordinator


This site provided for the swimmers and supporters of Derby Swim Club
© Derby Swim Club
Missouri Valley Swimming
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