Swim Lesson Form

Swim Lesson Form

Please fill in this form if you are interested in lessons & I will reach out to you about confirming your lesson within 2 days of receiving it. Contact me for details on pricing and questions. Email: cailinswimschool@gmail.com or Phone: 978-505-8573
Swimmer's Name*
Age/s*
Best way to contact: (Please list preferred)*
Address (Pool)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of Lesson*

PrivateSemi-PrivateGroup
Swim Experience*

Level 1Level 2Refresher
Preferred Day of Lesson*

SundayMondayTuesdayWednesdayThursdayFridaySaturday
Preferred Time of Lesson*

Morning (9-12)Afternoon (12-3)
Comments or Questions?
WAIVER / RELEASE OF LIABILITY

PLEASE READ CAREFULLY. THIS IS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS.

I give permission for my child/children to participate in Cailin Currie’s swim lessons. I understand that swimming is a hazardous activity with inherent risks and I assume on behalf of the above-named child/children all risk of loss, damage or injury arising out of participation in Cailin Currie’s swim lessons. On behalf of myself, the above-named child/children, my heirs, legal representatives and assigns, I hereby knowingly and intentionally hold harmless and release Cailin Currie, together with any sponsoring groups or clubs, and their respective directors, officers, agents, affiliates, employees, contractors, officials, sponsors, and volunteers, from and against any and all claims, actions, suits and demands pertaining to or arising directly or indirectly out of any damage, loss, illness, injury, or death as a result of participation in these lessons.
Signature

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COVID-19 Liability Waiver

I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

I further acknowledge that Cailin Currie can not guarantee not becoming infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, other clients and their families.

I voluntarily seek services provided by Cailin Currie and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19.
Signature

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