Product Purchase Form Web Site First Name * Last Name * Mobile Number * Email * Student Name * Items desired * Goggles Swim Diapers Accessories Triswim Comments If purchasing more than 1 of the same item, please provide the details. Consent * I agree that I have received the products indicated above, and acknowledge my permission for my card on file to be charged the total of the purchases. If I do not have a card on file, I agree that I am responsible for payment myself through my account. Staff Code *