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Questions? Call us!  California (818) 530-4117  Hawaii (808) 635-7062    
  
 

Pre / Supplemental / Additional
Payment Form
Happy Swimmers clients may also use this JTA CPR form for supplemental payments requested by our office.
Client Name: 
E-mail Address: 
Re-type Email: 
Training Date: 
   
Amt Paying Now: $
   
Notes for the Office: 
 
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