Swim Lesson LEVEL 3

Swim Lesson Level*

Swim Level 3 - Tuesdays/Thursdays September 9th - October 2nd - 6:20PM - 7:00PM

MEMBERNON-MEMBER

Participant's Name*

First NameLast Name

Participant's Birthdate*

Parent/Guardian Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number #1*

Please enter a valid phone number.

GROUP LESSON POLICY CONTRACT

Group Lesson Registration Procedures:

1. Parent/Guardian must complete a Group Lesson Registration form for their child. Each child needs to have their own registration form completed. Registration forms must be completed for each session.

2. Parent/Guardian must read this Policy Contract and sign below.

3. Provide payment to hold registration spot. (The BCC will contact you to make payment arrangements)

4. The Aquatic Director, or assigned individual, will confirm registration for each Family/Child.

5. Registration will remain open until 72 hours prior to the session starting or when the class is at maximum capacity. Families who wish to be put on the wait list may contact 763-200-4271. No payment is required to be placed on the wait list.

Group Class Size Policy:

Group lessons are required to have a minimum of 4 participants. If a class you registered for has less than 4 kids, we will honor the group lesson rate for 4 - 30min. private or semi-private sessions during the first four scheduled dates of your pre-registered class. Must be pre-registered at least 72 hrs. in advance.

Payment Policy:
Payment is required at registration. We accept VISA, MasterCard, Discover and American Express, Cash, or Check. We will contact you to take care of payment.

Inclement Weather Policy:
For the safety of all instructors and participants the community center will cancel group and private classes if Becker schools close due to the weather. This will be announced on the Becker Community Center Facebook page. Please call the BCC prior to your class time if you have any questions. The BCC will do their best to reschedule any cancelled classes due to the weather or other unforeseen incidences, if we are unable to reschedule a refund for that class amount will be provided.

Cancellation Policy:

· Cancellation requests made within at least two (2) weeks/fourteen (14) days of program start date = full refund.

· Cancellation requests made within one (1) week/seven (7) days of class start = 50% refund.

· Cancellation requests made less than one (1) week/seven (7) days of program start date = no refund given.

Missed Group Class Policy:

There are no make-up classes offered for Group Lessons that were missed.

Statement of Release

I agree to release the Becker Community Center, City of Becker, their employees and leaders of all liability related to accidents or injuries which myself or member of my family might incur while participating in the above mentioned activities. If necessary, I authorize the Becker Community Center to administer first aid and/or authorize medical treatment if this becomes necessary. Participants in the above-mentioned activities are not covered under the Becker Community Center’s or the City of Becker’s medical insurance policy

I, as the Parent or Guardian, give permission to the Becker Community Center, City of Becker, their employees and leaders of all liability related to accidents or injuries which myself or members of my family might incur while participating in any recreation program. In the event of injury or illness, every effort will be made to contact the Parents or Guardian. If necessary, I authorize the Becker Community Center to administer first aid and/or authorize medical treatment if this becomes necessary. Participants in the program are not covered under the Becker Community Center’s or the City of Becker’s medical insurance policy. If there is any need to contact the Parent or Guardian and they can not be reached, the BCC will contact the Emergency Contact. Only those listed who are authorized, will the child(ren) be released to with a photo I.D. I allow consent for the BCC staff to take photos of my child(ren) which may be used in marketing materials such as the seasonal brochure, flyer or City website

Please note registations submitted after 5pm will be contacted on the following day, please email ekeenan@ci.becker.mn.us if have payment questions.

Parent/Guardian Name*

First NameLast Name

Signature*

signature required

Payment must be made to confirm your BCC Swim Lesson Registration. You may call the BCC to pay, with a credit/debit card or BCC Staff will contact you to arrange payment. and to confirm registration and placement in class. Completion of this form does not guarantee placement in class. Placement in class will be confirmed by BCC Staff after payment has been received and class space is available.

LEVEL 3 - SWIMMING LESSONS