#BlackBabiesDoSwim Interest Form

#BlackBabiesDoSwim Waitlist

Since 2016, #BlackBabiesDoSwim is the only Black swim program in Pittsburgh/Allegheny County and we are so proud!
The #BlackBabiesDoSwimPGH initiative was created to combat the stigma that black kids do not swim or don't know how to swim. In 2014, the CDC found that an 11-year-old black child is 10 times more likely to drown than a white child the same age. The notion that "black people can't swim” may sound like a stereotype, but it's a real disparity and it's rooted in a history of discriminatory access to swimming pools. Throughout history blacks were denied access to pools with clean water, attacked at segregated pools and unable to join local swim teams/lessons or compete in Olympic swim events.

In 2017, USA Swimming, the governing body for the sport of swimming in the U.S., found that:

64% of African American children do not know how to swim (compared to 40% of Caucasian children).

79% of children in families that earn less than $50,000 a year do not know how to swim.

76% of parents report that their children would be more interested in taking up swimming if they saw a talented swimmer that looked like them.

Let's Work on changing these statistics!

Please note that by completing this enrollment form and enrolling your child in the #BlackBabiesDoSwim initiative that you release all liability from Melanin Mommies Inc and acknowledge that our role only serves as coordinator of swim events.

You also confirm that you are aware that mask cannot be worn in the pool area and release Melanin Mommies Inc from all liability in regard to the contraction, spread, or exposure to Covid 19 and any additional illnesses or injuries.

Lessons are held at the Thelma Lovette YMCA in the Hill District!
Sessions will be held Saturday and Sunday for 4 weeks!

Saturday Session 1: 9:15am
- Parent/Child 6 months-age 2
Saturday Session 2: 12:00pm
- Beginners Preschool Ages 3-5
- Beginners Youth ages 6-12.
Session 3: 12:30pm
- Beginners Preschool Ages 3-5
- Beginners Youth ages 6-12.
Sunday Session 1: 9:15am
- Parent/Child 6 months-age 2
Sunday Session 2: 12:00pm
- Beginners Preschool Ages 3-5
Session 3: 12:30pm
- Beginners Youth ages 6-12.
Pricing is as follows(Melanin Mommies has to include a $10 processing fee to cover funds transfers):

The YWCA has offered us the following pricing is per family registration.
$70 - (1) Swim Student +$10 processing fee
$140 - (2) Swim Students, or $65 per student +$10 processing fee
$205 - (3) Swim Students, or $65 per student + $10 processing fee
$50 - Each additional student if more than (3) +$10 processing fee
Parent's Full Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Post Code
E-mail*
example@example.com
Phone Number*

610400111000
Child 1: Full Name*

First NameLast Name
Age in Years*
Gender*

FemaleMale
Child 2: Full Name

First NameLast Name
Age in Years
Gender

FemaleMale
Child 3: Full Name

First NameLast Name
Age in Years
Gender

FemaleMale
Child 4: Full Name

First NameLast Name
Age in Years
Gender

FemaleMale
Does your child have any pre-existing conditions? (Asthma, epilepsy, anemia, etc? Please list*
Does your child have a learning disability that you would like to disclose to help instructors better understand your child's learning and behaviors?*
Has your child(ren) had consistent introduction to water in the past? (Example: Swim lessons, pool play, etc.)
Does your child have a fear of water?*

YesNo
What is your household income? (This is no way affects your enrollment)*

$0-$25,000$25,000-$50,000$50,000-$75,000$100,000+
What session will your child(ren) be attending?

Saturday Parent/Child 6 months-age 2: 12:00Saturday Beginners Preschool Ages 3-5: 12:30pmSunday Beginners Preschool Ages 3-5: 12:00pmSaturday Beginners Youth ages 6-10: 12:30pm
Please be informed that 3-5 year old and 6-12 year old sessions adults are not allowed to accompany the child in the pool for the lesson. 6 months-2 year old sessions do require an adult to accompany each child.
Photos and video may be taken during the sessions. Do you hereby grant {Melanin Mommies Pgh} permission to use you & your child(ren)'s likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration?
Signature*

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How did you hear about us?*
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#BlackBabiesDoSwim Waitlist