SFSC Scholarship

Institution / Organization Name*

Institution must be listed in order to be eligible.

Swimmer's Name*

First NameLast Name

Parent/Guardian's Name (If Applicable)

First NameLast Name

Participant's Date of Birth*

Date

Race Identity*

Education Status

Address*

Street Address & Apt

Street Address Line 2

CityState

Zip Code

Email*

Confirmation EmailRetype Email

Mobile Number*

Format: 0000000000.

Location*

Has the participant taken lessons before?*

YesNo

Comfort Level*

The participant can... (Select all that apply)*

Does your household currently qualify for SNAP (EBT) benefits?

Are you currently employed?

What is the combined income of your household per year?

In at least 2-3 sentences: What are your future plans in swimming, and how does this scholarship fit into achieving those goals?*

OUR MISSION
To provide opportunities for children from minority communities and families of financial hardships educational experiences in and around aquatic environments. These lessons will develop water safety awareness to reduce and prevent drowning. Furthermore, additional skills are introduced from a competitive swimming perspective to encourage swimming as recreational exercise and create various opportunities.

This introduction of fitness and a team atmosphere provides benefits to our community by developing discipline, commitment, and dedication to a healthy lifestyle.

SCHOLARSHIP REQUIREMENTS

• A maximum of 1 absence is allowed per month, which can be made up

• All absences must have a valid excuse, which will require proof of a doctor’s note if health related

• Student may not have more than 2 lateness markers per month

• Student must complete the full semester or season of the program associated with this scholarship

Failure to honor these requirements will result in removal from the program and ineligibility to apply to any future scholarships.

This application must be completed with the most accurate information along with proof of income and any financial assistance if requested.

Applicant Attestation: By my signature below, I declare and affirm that I have read and fully understand that: Any misrepresentation or material omission of facts in this application or in any other materials I submit in support of my child or children(s) candidacy including but not limited to this application and proof of documents, or in any oral or written statements I may make during the selection process shall be sufficient cause for denial of Splash Fit Swim Club’s selection process or shall be sufficient cause to end further consideration of my application prior to being selected;

I authorize Splash Fit Swim Club Inc. to make any necessary inquiries and investigations into my employment history. I further authorize, unless otherwise indicated on this application, the release of my information to Splash Fit Swim Club, Inc. by any of the schools, services, or employers listed on this application.

I fully understand that failure to meet the scholarship requirements above will forfeit my deposit and spot in the program.

PARTICIPANT HEALTH HISTORY
At Splash Fit Swim Club, our student's mental and physical wellbeing is the most significant priority to us. All participants with any health issues should see a physician before beginning any kind of physical activity. Please inform us of any current or former health issues that the applicant feels would hinder his/her ability to learn or of any physical complications that can create obstacles during the student's learning experience.

AS THE PARENT/GUARDIAN

Children ages 17 & under are not allowed to be left alone in any facility where classes are being held. It's extremely crucial that you are present at all times. Instructors/coaches are professionals who have been teaching for years; therefore, distracting instructors/coaches during a class is unacceptable. It is imperative that you do not compare your child’s ability to progress to that of any other child participating in his/her class. The participant should be focused and fully prepared to learn. Children learn at their own pace and criticizing them in any aspect would be severely demoralizing towards their confidence and development. If you have any questions or concerns you’d like to address please present them either before or after class, time permitting.

FACILITY RULES

It is important that we respect all facility rules when in attendance to ensure the safety of our children and ourselves. Please be sure to take note of each facility's specific rules and share them with your children and whoever accompanies them to their lessons. Shoes aren’t allowed on any pool deck. All participants must change in designated locker rooms; deck changing is absolutely not permitted.

CANCELATION & MAKEUP POLICIES

It is important that the classes you acquire fit your schedule. Missing too many classes or constantly arriving late can impact progress, disturb continuity and cause the student to fall behind. Whether the student makes it to class or not, instructors are still present. Contact us if you feel you may cancel class for any reason at least 24 hours ahead. Requesting a future absence is required in order to receive a makeup token on our app or member portal.

All members can redeem up to 1 makeup token a month | An "Absence Request" must be submitted through The Splash Fit App or member portal at least 24 hours prior to the missed class.

If any cancelations occur for any reason on our behalf, a makeup class is granted at absolutely no cost to you. In the event that our cancelation is immediate due to either an instructor/coach’s absence or a facility/maintenance issue, we will give our best efforts to contact you via phone, email and text message as soon as possible. Please be reasonable in understanding that cancelations may occur moments prior to your scheduled class.

CONCUSSION AWARENESS-PREVENTION GUIDELINES

The following constitute the policies of Splash Fit Swim Club or “SFSC” regarding concussion awareness and prevention within our organization. SFSC is committed to maintain an adequate system and regularly promote a concussion awareness and safety recognition program, including, but not limited to, the online Concussion Course offered by the Centers for Disease Control and Prevention. SFSC communicates, in writing (including by electronic means), our concussion awareness and safety recognition program to all participants, coaches, parents and involved parties. SFSC has a clear understanding of concussion and the potential consequences of the injury; recognizing concussion signs and symptoms and how to respond. SFSC is focused on prevention and preparedness to help participants stay safe and learn the steps for returning to activity after a concussion.

Splash Fit Swim Club will take the following 5 steps if we suspect a participant has a concussion:

1. Remove the athlete from play. Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, keep the athlete out of play.
2. Ensure that the athlete is evaluated by a health care professional experienced in evaluating for concussion.
3. Recording the following information can help health care professionals in assessing the athlete after the injury:
• Cause of the injury and force of the hit or blow to the head or body
• Any loss of consciousness (passed out/knocked out) and if so, for how long
• Any memory loss immediately following the injury
• Any seizures immediately following the injury
• Number of previous concussions (if any)
4. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion. Make sure they know that the athlete should be seen by a health care professional who is experienced in evaluating for concussion.
5. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says he/she is symptom-free, and it’s OK to return to play.

A repeat concussion that occurs before the brain recovers from the first concussion—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.

BILLING AUTHORIZATION

I represent and warrant that if I am purchasing something or paying for a service from Splash Fit Swim Club ("SFSC") or from other merchants through SFSC that (i) any credit card or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties.

I hereby authorize (if online payment is made or autopay information is provided) Splash Fit Swim Club to charge my ACH draft, credit or debit card account. I am responsible for payment whether I or my student attends classes or not. Should I dispute a charge through my financial institution this will constitute a breach of contract possibly resulting in, but not limited to, penalties, additional fees, collection, legal action, and/or termination of any and/or all current and future services.

LIABILITY/WAIVER & AUTHORIZATION

I hereby authorize any representative of Splash Fit Swim Club to arrange to treat Participant(s) for injury in any medical emergency during participation in aquatic activities under their supervision. I hereby waive, release and forever discharge and agree to indemnify and hold harmless Splash Fit Swim Club, any facility in which their program takes place, their shareholders, owners, members, directors, officers, agents and employees (the “Released Parties”) from any and all actions, suits, demands, claims, damages, attorney fees, and causes of action of any type or kind whatsoever arising out of or caused by the participant(s) in any aquatic activities at Splash Fit Swim Club and/or it’s facilities. I also give full permission for the use of photography for advertisement purposes.

I HAVE CAREFULLY READ THE “TERMS, CONDITIONS & COVID RELEASE POLICY” OF THIS REGISTRATION FORM AND SIGN IT WITH FULL KNOWLEDGE OF ITS CONTENTS AND SIGNIFICANCE.

*

AGREE

SIGNATURE*

Current Date

Date

DATE*

Age

What is the combined income of your household per year?

TERMS AND CONDITIONS