Duty Status:   Branch of Service:   Marital Status:


Children?                  If you have Children how many?


Rate Your Physical Fitness:      Rate Your Swimming Ability:

T-Shirt Size:     Should we put you on a waitlist if full?:  

Physical Limitations:
    











Sex:
Date of Birth:
Duty Status:
Branch of Service:
Marital Status:
Children?:
If you have Children how many?:
Physical Limitations:
Rate Your Physical Fitness:
Rate Your Swimming Ability:
Should we put you on a waitlist if full?:
Additional Comments:
T-Shirt Size: