Name *

First Name

Last Name

Are you a current TEXINS member? *

Must be a current TEXINS member to participate in this program.

Yes

No

Choose which session(s) you would like to attend. *

Each session is $40.

Session 1 - May TBD

Session 2 - June 4, 11, 18, 25

Session 3 - July 2, 9, 16, 23

Mommy-n-Me: Introduction to Water Skills is a paid program, please select your non-refundable payment method below. *

Payroll Deduction - REQUIRED for TI employees. I would like to pay for Mommy-n-Me through payroll deduction. By selecting this option you are authorizing Texins to proceed with a payroll deduction charge for each registered session.

Credit Card - REQUIRED for TI Family members, Contractors and Co-locaters. Please provide credit card payment at the Texins Fitness Center front desk the Wednesday before your scheduled session. If payment is not provided by the deadline you will not be able to participate in this program.