Freeport Lifeguard Competencies Workshop 2024 Registration

Candidate Name

DwightGrant
WaterProof242 Lifeguard Competencies Workshop

FREEPORT July 24-26, 2024 Registration Form
Email*
Kingrolie234@gmail.com
Phone Number*
242 4391893Format: (000) 000-0000.
Cohort 1 Mornings Jul 24-26, 2024
Cohort 2 Afternoons July 24-26, 2024
Emergency Contact

NameRedlationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Candidate Age
Birth Date

MonthDayYear
Are you a Bahamian Citizen*
I have Government issued identification
Are you employed*
Do you have previous experience as a lifeguard*
Level of swimming skills*
I can swim using recognizable Breast stroke or Freestyle*
Swimming Skills
Distance swim using Breast stroke or Freestyle*
Swimming Skills
Swim 20yds retrieve a 10lb brick from 4 surface and swim 20yds return and exit IN 1:40min*
Swimming Skills
I can tread water for 2minutes*
Swimming Skills
Is there anything we should know ? (allergies, health, if no please type N/A)
INFORMED CONSENT AND ACKNOWLEDGEMENT

I assume all risks and hazards incidental to the conduct of the activities and release, absolve, and hold harmless WaterProof242 and all its respective officers, agents, and representatives from any and all liability for injuries arising out of selected camp sessions.
In case of injury I hereby waive all claims against WaterProof242 including all instructors, coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports
activities, including swimming.

MEDICAL RELEASE AND AUTHORIZATION In the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor's life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is also granted to Waterproof242 and its affiliates including Directors, Instructors, and Coaches to provide the needed emergency treatment prior to the child's admission to the Medical facility.

This release is authorized and executed of my own free will.

Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN
ORIGINAL MANUAL PAPER SIGNATURE.
Signature
Date

MonthDayYear
Date
Should be Empty:

WaterProof242 Lifeguard Competencies Workshop