Swim Lesson Registration Form
Held at Essexville Garber High School-Session One:June 22-26
Parent Name/Guardian Signing up Child
First Name
Last Name
Email (used for program updates only)
example@example.com
Mobile number for updates
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Swimmer's Name
First Name
Last Name
Swimmer's Birthday MUST BE 4 YEARS OLD BY 06/01/26
-
Month
-
Day
Year
Date
I understand lessons will be assigned from 4:30-7pm . All times will be assigned. Families will be placed together. ALL children MUST be able to perform in a group setting.
*
YES
I am registering more than one child(siblings only)
Please share your child's water experience
*
will fully submerge
will fully submerge and can float unassisted
has had previous swim lessons
new to swim lessons but is comfortable in the water
new to swim lessons and is not comfortable in the water
will swim in deep water unassisted
Please acknowledge the following:
By registering for lessons, I acknowledge and agree that my child may appear in photos and/or videos used by Pool School for promotional, marketing, and social media purposes
You are a resident of Bay County
Yes
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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