Tortuga Tots Registration Form 2024
Parent's Name
First Name
Last Name
Today's Date
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Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email: (This email will be used to send lesson reminders and invoices)
example@example.com
Other guardian(s) that may also bring child to lessons (other parent, grandparent, nanny, etc.)
Were you recommended to Tortuga Tots Swim Academy? If so, please let us know who to thank! If not, how did you hear about Tortuga Tots and Jessica Boes?
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Swimmer(s) Info
If there is more than one swimmer, click on the drop down menu at the bottom to add more.
Swimmer(s) Info
First Name
Last Name
Age
Birthdate
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Primary Physician's Name
List any and all physician's, therapists, or other medical personnel this child has been seen by and the purpose for the visit EXCLUDING well check-ups as well as any physical exceptionalities:
More than one swimmer? Click here to enter more.
Swimmer 2 Name
First Name
Last Name
Age
Birthdate
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Primary Physician's Name
List any and all physician's, therapists, or other medical personnel this child has been sen by and the purpose for the visit EXCLUDING well check-ups as well as any physical exceptionalities.
Swimmer 3 Name
First Name
Last Name
Age
Birthdate
-
Month
-
Day
Year
Date
Gender
Please Select
Male
Female
Primary Physician's Name
List any and all physician's, therapists, or other medical personnel this child has been seen by and the purpose for the visit EXCLUDING well check-ups as well as any physical exceptionalities:
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Is your child a student at Grow Preschool?
Yes
No
Do you live in Grey's Landing?
Yes
No
How did you hear about Tortuga Tots Swim Academy?
What session and time slot would you be interested in? (Your lesson will be a 10 minute time slot, if you have more than one swimmer, I will try to schedule them consecutively.) I will contact you after I receive this form and we will review availability. Your schedule will be guaranteed upon payment.
Refresh 4/22-5/3
2-3pm
3-4pm
Session 1 - 5/13-6/14
7:30-8am
2-3pm
3-4pm
Session 2 - 7/8 - 8/16
7:30-9:00am
9-10am
10-11:30am
2-3pm
3-4pm
4-5pm
5-6pm
Session 3 9/9-10/11
7:30-8am
2-3pm
3-4pm
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Release of Liability
I understand photos and/or videos may be taken during lessons and used for promotional reasons for Tortuga Tots LLC, Tortuga Tots Swim Academy. Tortuga Tots Swim Academy will not share or sell any photos or videos to any third parties.
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Agree
Disagree
I give permission for me/my child to participate in aquatic activity. I/my child is in good health and physical condition, and am/is not suffering from any condition that would prevent me/my child from engaging in this activity. Photographs and video may be taken in conjunction with lessons. I understand and agree that they may be used for informational and advertising purposes.
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Please read carefully and be aware that in registering your minor child for participation in this program, you will be waiving and releasing all claims for injuries you or your child might sustain as a result of participation in any class or activity conducted by Tortuga Tots Swim Academy, its agents and employees. As a parent/guardian of a participant in Tortuga Tots Swim Academy, I recognize and acknowledge that there are certain risks associated. I agree to assume full responsibility of any injuries, property damage, or loss, which I, or my minor child, may sustain as a result of participating in any and all activities connected with or associated with Tortuga Tots Swim Academy. I agree to indemnify and hold Tortuga Tots Swim Academy harmless from any liability resulting from the use of premises and participating in any Tortuga Tots Swim Academy program. I have read and fully understand the above waiver and release of all claims, and it shall not be modifies orally.
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I understand that payment is due IN FULL prior to start of classes each week. I have acknowledged that payment policy and understand there are NO REFUNDS.
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I understand that Tortuga Tots Swim Academy offers NO MAKE-UP LESSONS unless lessons are cancelled by Tortuga Tots Swim Academy due to weather or facility conflicts. If my child will be out for an extended period of time due to illness I will contact Tortuga Tots Swim Academy to make proper arrangements.
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