YMCA Lifeguard Training Forms
  • READ THIS ENTIRE DOCUMENT. SIGNATURES ARE REQUIRED AT THE BOTTOM.

    Thank you for enrolling in a YMCA of Greater Charlotte Lifeguard course. The Y believes that preventing an accident and saving a life is worth the hours of training and dedication essential to becoming a competent lifeguard. YMCA- certified lifeguards have a serious responsibility to prevent accidents and handle emergencies properly. It is imperative that lifeguards and aquatic safety assistants are physically trained, mentally alert, and have the maturity to safely guard an aquatic area.

    We expect you to demonstrate your maturity at all times during classroom and pool instruction by:

    • Participating in ALL class, pool, and practice sessions
    • Arriving promptly and prepared with a picture ID or other proof of age
    • Presenting a positive attitude and courteous class conduct
    • Making an appointment with the instructor when you have difficulty understanding the material presented or if you have specific testing needs
  • To complete the course successfully, you will be required to perform the following:

    • Demonstrate competency in each critical skill taught in the course; competency is defined as being able to perform each critical skill correctly and without guidance
    • Successfully complete CPR Pro for the Professional Rescuer (including AED), First Aid for the community, and Emergency Oxygen Administration certifications.
    • Successfully complete water tests and all scenarios
    • Pass all written exams with at least an 80% score. The YMCA Lifeguard Exam requires an 80% score or better on each section of the exam to pass.
    • Pass the following Pre-requisit swim assessment requirements.
  • You also must be able to accomplish these tasks:

    • Sit for extended periods of time in an elevated chair. A candidate must remain alert and focused on the entire zone of responsibility for extended periods of time, even under conditions of high heat and humidity, with no lapses in consciousness. Move safely to various locations, including entering and exiting an elevated chair, while scanning the zone of responsibility.
    • Communicate with others immediately when responding to an accident or an emergency. Candidates must be able to communicate verbally, including projecting their voice across distances, communicate swiftly and clearly with emergency personnel over the telephone or in person; and effectively give and receive directions
    • Hear noises and distress signals in the aquatic environment, including in the water and anywhere around the zone of responsibility. Candidates must understand that significant background noise exi9sts in all indoor and outdoor aquatic environments. In addition, lifeguard candidates should have a minimum hearing threshold of no more than a 25-decibel loss in both ears over the range of frequencies (500 Hz, 1000 Hz, 2000 Hz, 788 and 3000 Hz Candidates who use hearing aids or other corrective devices for hearing should be able to perform all rescue skills and emergency procedures without interruptions to adjust, retrieve, install or attach hearing aid/corrective device. Remain alert with no lapses of consciousness.
    • Observe all sections of an assigned zone or area of responsibility. Candidates who use corrective eyewear should be able to perform all rescue skills and emergency procedures without interruptions to adjust, clear, or retrieve corrective eyewear.
    • Perform all rescue, resuscitation and survival skills. Candidates must be able to perform basic first aid such as manual suction, use a bag-valve mask resuscitator, administer emergency oxygen, use an AED (automated external defibrillator), and perform professional rescuer CPR.
    • Think in the abstract, solve problems, make quick decisions, instruct, evaluate, supervise and recognize the potential for danger or injury.
    • Have adequate memory skills and be able to retain and apply the knowledge learned in lifeguard training
    • Act swiftly in an emergency and take action even when unsure whether a person is really in danger.
  • By enrolling in the course you are attesting that you can perform all of the above tasks.

    In addition, you must complete all eLearning assignments and turn in all eLearning certificates according to the schedule set by your instructor. The total eLearning time is approximately 7 hours.

    All e-learning for CPR/First Aid/Emergency Oxygen and lifeguard are required to be completed by the first day of class. If these are not completed you will not be allowed to attend the class.

    • You will need to purchase the following:
    • Fox 40 whistle (required)
    • Enccouraged to have your own Lifeguard fanny pack CPR mask with one way valve

    Paying the course fee does not guarantee certification. Upon successful completion of the course, you will receive a Lifeguard certification.

    • The YMCA Lifeguard certification, Basic First Aid and Emergency Oxygen Administration are valid for two years. The YMCA CPR Pro for the Professional Rescuer is valid for one year. YMCA Lifeguard certification is only valid if all required certifications are kept current. Afterone year, you will need to renew your CPR Pro for the Professional Rescuer certification and send proof to YMCA of the USA to keep your YMCA Lifeguard certification current.
    • The American Red Cross Lifeguarding Certification, CPR Pro for the Professional Rescuer, Basic First Aid and Emergency Oxygen are valid for 2 years.

    The Y looks forward to teaching the knowledge and skills needed to be a YMCA Lifeguard.

  • Release and Waiver of Liability

    You have registered for a YMCA of the USA or American Red Cross certification course that includes a practical component.  Because the practical component of this course includes physical activity, completion of this Waiver of Liability form is required.

     THIS DOCUMENT IS A RELEASE OF CLAIMS, AND BY SIGNING IT YOU DO THE FOLLOWING:

    1.       Acknowledge that when performing the physical activities related to the practical component of this course, you may suffer injury.

    2.       Represent to the YMCA of the USA that you are in good health and physical condition, sufficient to engage in such activities and that you are not suffering from any condition that would prevent you from engaging in such activities or that make your engagement in such activities potentially dangerous or harmful to you.

    3.       ASSUME THE RISK OF, AND RELEASE AND HOLD THE YMCA OF THE USA, AND/OR ANY OTHER YMCA ENTITY, HARMLESS FROM ANY LIABILITY FOR ANY PHYSICAL OR OTHER INJUURY OR HARM SUFFERED BY YOU DURING, OR AS A CONSEQUENCE OF, PARTICIPATION IN THE PHYSICAL ACTIVITIES REQUIRED IN THE CURRICULUM FOR THIS COURSE AND YOU AGREE THAT NEITHER THE YMCA NOR THE FACILITY AT WHICH THIS COURSE IS BEING CONDUCTED NOR ANY OTHER PERSON INVOLVED IN THE ORGANIZING OR TEACHING THIS COURSE SHALL HAVE ANY LIABILITY OR RESPONSIBILITY FOR ANY INJURY OR HARM.

  • Print Candidate's name:

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  • I have read and agree to the above requirements. I grant the candidate above permission to participate. I have carefully read, understand, and affirm that I am in good health and physical condition, and am signing this of my own free will. I agree to all of the foregoing.

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  • Printed Parent/Guardian's name:

  • Clear
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