Junior Swim Program - 2024/2025 Winter Session

Junior Swim Program - 2024/2025 Winter Session

Please complete this form for each child registering for the program.
Winter II: 12/2/2024 - 3/14/2025

(No clinics 12/23-1/1 & 2/17-2/22)
PARTICIPANT INFORMATION
What is your affiliation with Wightman Tennis Center?*

MemberWait ListNon-member
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Please upload a current photo of your child for their account. *

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REGISTERING FOR:*

WINTER SESSION ONLYWINTER AND SPRING (I acknowledge the pricing may change from session to session due to the number of classes in each session.)
Please select a program:*

Youth 1 (Ages 4-5)Youth 2 (Ages 5-6)Junior 1 (Ages 6-8)Junior 2 (Ages 8+)In-House Swim Team
Please choose class time(s) below.
YOUTH 1 - 30-minute class (Ages 4-5)

MON., 3:30 - 4:00 p.m. (12 weeks: $360 member; $600 non-member)
YOUTH 2 - 30-min. class (Ages 5-6)

MON., 4:00 - 4:30 p.m. (12 weeks: $360 member; $600 non-member)
JUNIOR 1 - 30-min. class (Ages 6-8)

MON., 4:30 - 5:00 p.m. (12 weeks: $360 member; $600 non-member)WED, 4:30 - 5:00 p.m. (12 weeks: $360 member; $600 non-member)THU, 3:30 - 4:00 p.m. (13 weeks: $390 member; $650 non-member)
JUNIOR 2 - 1-hour class (Ages 8+)

THU., 4:00 - 5:00 p.m. (13 weeks: $520 member; $780 non-member)
IN-HOUSE SWIM TEAM - 1-hour class (Ages 10-12)

MON., 5:00 - 6:00 p.m. (12 weeks: $480 member; $720 non-member)
PARENT / GUARDIAN INFORMATION
Parent / Guardian 1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent / Guardian 2

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
EMERGENCY CONTACT INFORMATION

In the event a parent/guardian cannot be reached, please provide an emergency contact. A designated emergency contact must be at least 18 years of age or older.
Emergency Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.
PAYMENT AND REGISTRATION
- Clinics will be prepaid for each full session at the time of registration, with no refunds due to high demand. If you do not have a Wightman account or credit card on file, a club representative will contact you to complete the payment process. Please note that credit card transactions incur a 3% convenience fee, and registration is not finalized until payment is received.
- In the event that clinics are canceled, a refund will be provided for missed classes.
- Registration will be made on a first come, first served basis. For any questions about clinic placement or guidance, please contact Matt Brooks at matt@wightmantennis.org.
SWIM CLINIC POLICIES
Club rules will be in place for all clinics. Wightman seeks to promote a positive experience for all junior program participants.

Make-ups available only with prior notice and if space allows. Missed classes must be made up in the same session.
WAIVER OF LIABILITY
WAIVER OF LIABILITY*

I understand that it is the intent of the Program and of Wightman to ensure my safety and/or that of my child(ren). On behalf of myself, and/or my child(ren), I hereby assume all risks related to participation in the Program, including but not limited to possible exposure to the SARS-CoV-2 virus, that may lead to accident, illness, permanent disability, injury, or death, including personal, bodily or mental injury of any nature. I hereby certify that I understand the nature and extent of the risks inherent in participation, and in the use of facilities, equipment or services in association with the Program.I understand that participation in this Program is completely voluntary and I agree to assume all of the foregoing risks and accept sole responsibility for myself and/or my child(ren). It is my responsibility to ensure that I and/or my child(ren) participate only in activities for which I and/or my child(ren) possess appropriate skills, qualifications, training and physical conditioning.On behalf of myself and/or my child(ren), I hereby assume all risks related to participation in the Program. I further hereby, on behalf of myself, and/or my child(ren), and anyone claiming through myself and/or my child(ren), do FOREVER RELEASE Wightman, its officers, directors, employees, members, agents, and assigns from any cause of action, claims, or demands of any nature whatsoever, including but not limited to a claim of negligence which I, and/or my child(ren), or anyone claiming through myself and/or my child(ren), may now or in the future have against Wightman on account of personal injury, bodily injury, property damage, death or accident of any kind, arising out of or in any way related to my participation and/or that of my child(ren) in the Program howsoever the injury is caused.I understand that this Program is not a medical or health care program. I have no expectation of any medical or health benefit to myself and/or my child(ren) from participation in the Program. I certify that I and/or my child(ren) am/is/are medically able to participate in the Program and am/is/are free from any communicable, infectious or contagious diseases. IN CASE OF EMERGENCY such as accident or injury, I give permission to the Program to provide assistance and to procure emergency medical care in the event that I or person(s) I designate cannot be reached. By signing below, I certify, on behalf of myself and/or my child(ren) that I have read and understand the contents of this document. My signature is proof of consent and release for myself and/or my child(ren) to participate in this Program.
Participant Name

First NameLast Name
Parent / Guardian Name

First NameLast Name
Relationship to Participant
Parent / Guardian Signature*

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Junior Swim Program - 2024/2025 Winter Session

PARTICIPANT INFORMATION

PARENT / GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

PAYMENT AND REGISTRATION

WAIVER OF LIABILITY