USMS 2017 NEW MEMBER Registration
Personal
Info
Waiver Affiliations Options Review /
Payment

Member Identification

First Name:
Middle Initial:
Last Name:
Suffix:
Birth Date:
Gender:

Mailing Address

Country Abbr: USSearch Countries
Select the country from the list below, then click "Choose This Country".
Your selection will be added to the country field.



Choose This Country
Street:
City:
State:
Zip Code:

Contact Details

Primary Phone:
Contact via Text?
Secondary Phone:
Contact via Text?
Alternate Phone:
Contact via Text?
Email Address (P):
Confirm Email (P):
Email Address (S):
Confirm Email (S):

Your Swimming Roles

More About You

My primary swimming interests are: (check all that apply)
USMS Wave Seperator

All 2017 registrations expire on December 31, 2017.

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