Heights Pool - Registration 2022

Beaconsfield Heights Community Swimming Pool Association
Registration 2022
The registration form is to be used for members that reside at the same address. If you are completing registrations for members that live at different addresses, please complete a separate registration form specific to each address.
En raison d'un manque de bénévoles, le formulaire d'inscription n'est actuellement disponible qu'en anglais. Toutes nos excuses pour tout inconvénient lors de l'inscription. Soyez assuré que tout le personnel de la piscine est bilingue et que les services seront offerts en français et en anglais.
Need help? Questions? Please contact us at piscineheightspool@gmail.com

Member Contact Information:
Enter the information that applies for the family residence
Family Last Name*
Primary Email Address*
example@example.com
Secondary Email Address
example@example.com
Primary Phone Number*

Area Code Phone Number
Secondary Phone Number

Area Code Phone Number
Address*

Street Address
Street Address Line 2
City Province
Postal / Zip Code Country

Adult Registration
18+
Name

First Name Last Name
Programs you will participate in:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Do you wish to add an individual to this membership?*

YesNo

Senior Registration
60+
Name

First Name Last Name
Programs you will participate in:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Do you wish to add an individual to this membership?*

YesNo

Teen: Leisure Swim
12-17
Teen Name

First Name Last Name
Birth Date:

MonthDay Year
Date
Do you wish to add an individual to this leisure swim membership?*

Yes - go back and select Small Family: Leisure membershipNo
Please Note: With this membership, teens are NOT registered to participate in any aquatic programs or teams
If you would like to register for these services, please return and select "Teen: Program Membership"

Additional Leisure Swim
First Add-On
Name

First Name Last Name
Adult and senior programs you will participate in:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Do you wish to purchase an additional leisure swim membership?*

YesNo

Additional Leisure Swim
Second Add-On
Name

First Name Last Name
Adult and senior programs you will participate in:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Do you have another additional membership to add?*

NoYes - go back and change your membership to a Family Leisure Swim Membership

Family Leisure Swim
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Programs for any adult or seniors on this membership:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Please Note: With this membership, children are NOT registered to participate in any swimming lessons or aquatic programs
If you would like to register for these services, please return and select "Family Rate"

Small Family Leisure Membership
Adult Name

First Name Last Name
Programs for any adult or seniors on this membership:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Child Name

First Name Last Name
Birth Date

MonthDay Year
Date
Do you wish to add an additional parent to this membership?*

YesNo
Please Note: With this membership, children are not registered to participate in any swimming lessons or aquatic programs
If you would like to register for these services, please return and select "Small Family Rate"

Small Family:
Additional Child
Name

First Name Last Name
Birth Date

MonthDay Year
Date
Do you wish to add an individual leisure swim membership?*

NoYes - go back and select a Family Leisure Membership

Small Family:
Additional Adult
Name

First Name Last Name
Do you wish to add an individual leisure swim membership?*

NoYes - go back and select a Family Leisure Membership

Family Membership:
Adult Registrations
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Programs for the adults and seniors on this membership:

Early Bird Swim (Mon - Thurs, 7 to 8am)Shallow End Water Workout (Monday to Thursday 1:30 to 2:00)Masters Swim Conditioning and Stroke Improvement (Tuesday & Thursday, 8 to 9pm)Masters Swim Conditioning and Stroke Improvement (Monday to Thursday 1:30 to 2:00)Deep End Water Workout (Monday to Thursday 10:30 to 11:00)
Do you wish to register any children?*

YesNo - please go back and select Family Leisure Swim

Babysitter:
You may register a Babysitter for your child(ren). The babysitter must be at least 12 years of age. Babysitters can only swim when accompanying your family.
Name of Babysitter

First Name Last Name

Volunteer Activities
Heights is a community pool 100% run & operated by its members. Heights Pool relies on YOU to help create a fun and community atmosphere at our pool.

Thanks to the support of our members, we are able to:
- Create fun social and athletic events
- Run our delicious and super affordable canteen, which our kids and guards absolutely LOVE!
- Keep the grounds of our community pool looking inviting
- And basically make our pool the best place to spend your summer
There are so many ways to get involved!!
- use your handy skills during maintenance days
- give a couple of hours to a swim meet
- volunteer at one of our social events
- share one of your skillsets (fundraising, marketing, accounting, translating, webmaster, gardening, let us know what you can contribute!)
- serve on the board of directors
- and more...
Please keep an eye on your email inbox and offer to volunteer as needed - our community is depending on you!

Photo Upload
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Photo should display all registered members.

*** This photo will be used solely for security and identification purposes.
Upload existing Photo

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Take a Photo! Gather the members and Say Hammerheads!

Code of Conduct
Terms and Conditions of Membership
Heights Code of Conduct: Heights promotes a safe, respectful and inclusive environment for all of its members and staff. No verbal or physical harassment of any kind will be tolerated, as well as any conduct that would jeopardize one’s own safety and/or the safety of others. Individuals who display this type of conduct will be asked to leave the pool area. Please click here for the Heights Code of Conduct.

ALPS Code of Conduct: Heights is a member of ALPS and therefore its code of conduct applies to all member pools as well as their athletes, parents, coaches, officials and spectators for events at home or away meets. Please click to read the ALPS Code of Conduct.

Payment
Total Membership Fee Due to Complete Registration:
Membership Fee 2022:
Please double-check fee structure below; the automatic calculation may have errors due to the 31 (!) possible membership combinations this season - we tried our best!
Payment type:

e-transfer (preferred method)cashcheque
E-transfer Instructions

Send it to: piscineheightspool@gmail.com

AUTOMATIC DEPOSIT IS ENABLED. PLEASE INCLUDE FAMILY NAME AND REGISTRATION NUMBER AS A MESSAGE WITH YOUR E-TRANSFER.

If required by your bank:

Security Question: Any

Security Answer: Heights2022
Cheque Instructions

Make cheque payable to: BHCSPA

Place inside a sealed enveloppe

Give to: Lifeguards to put inside the secure Treasurer box

OR

Mail to: 3551 St. Charles Blvd, Suite 434 Kirkland QC H9H 3C4

Please write your Confirmation Number and/or Family name on the enveloppe and on the cheque.
Cash Instructions

Place inside a sealed enveloppe

Give to: The lifeguards to put inside the secure Treasurer box

OR

Mail to: 3551 St. Charles Blvd, Suite 434 Kirkland QC H9H 3C4

Please write your Confirmation Number and/or Family name on the enveloppe
Should be Empty:

Beaconsfield Heights Community Swimming Pool Association

Member Contact Information:

Select your Membership:

Adult Registration

Senior Registration

Teen: Leisure Swim

Please Note: With this membership, teens are NOT registered to participate in any aquatic programs or teams

Small Family Membership

Teen: Programs Membership

Additional Leisure Swim

Additional Leisure Swim

Family Leisure Swim

Please Note: With this membership, children are NOT registered to participate in any swimming lessons or aquatic programs

Small Family Leisure Membership

Please Note: With this membership, children are not registered to participate in any swimming lessons or aquatic programs

Small Family:

Small Family:

Family Membership:

Family Membership:

Family Membership:

Family Membership:

Family Membership:

Family Membership:

Family Membership:

Young Family Membership:

Young Family Membership:

Young Family Membership:

Young Family Membership:

Babysitter:

Volunteer Activities

Photo Upload

Code of Conduct

Payment