2026 Swim4Nick Swim Clinic Aug 23rd Registration Form

2026 Swim4Nick Swim Clinic Aug 23rd Registration Form

If under 18 Parent/Guardian Must Complete This Form!
Location: Plantation Aquatic Complex, 9151 NW 2nd St, Plantation, FL 33324

Time: 9am-12pm

This is a swim stroke clinic, NOT swimming lessons. Swimmer should be familiar with the four strokes before attening the clinic. If your child is younger than 10 yrs old, please contact us.
Swimmer Name

First NameLast Name
Parent Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Shirt Size
Adult unisex shirt
Age
E-mail
Swim Club/Team Name
Name of your swim team or club.
Waiver of Liability

If under 18 your parent must complete this registration.

This agreement releases Nicholas Dworet Memorial Fund Inc. Dba Swim4Nick, from all liability relating to injuries that may occur during any swim event. By submitting this registration form, I agree to hold Nicholas Dworet Memorial Fund Inc. entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence.

I also acknowledge the risks involved in swimming. These include but are not limited to drowning or any phyisical injury. I swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity.

By summitting this form I forfeit all right to bring a suit against Nicholas Dworet Memorial Fund Inc. for any reason. In return, I will receive swim coaching instruction. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed.
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