AHS Swim Camp Registration

AHS Swim Camp Registration
Dates: Thursday, 7/16-Saturday, 7/18

Time: 9-11 AM

Mini Meet: Saturday, 7/18, 11 AM-12 PM (Parents are welcome to attend!)

Open to: 2nd–8th graders as of Fall 2026; all school districts

Fee: $40 per student

Registration deadline: June 26th (To get a camp t-shirt!)

Participants must be able to swim a full lap without stopping; this is not considered swim lessons.

Questions? Please contact AHS head swim coach, Nicole English at nicole.english@ayersvillepilots.org
Participant Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Participant Grade as of Fall 2026
School/School District
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
T-shirt Size
Emergency Medical Form
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Relationship to Participant
Allergies or Medical Conditions
Current Medications
Physician Name

First NameLast Name
Physician Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Preferred Hospital
Hospital Phone Number
Permission for Emergency Medical Treatment
Acknowledgment that this is not considered swim lessons
Acknowledgment that participant can swim a full lap without stopping
Parent/Guardian Signature
Date Signed

MonthDayYear
Date
Payment
Payment must be made by or on the first day of camp via cash or check. Please make checks payable to Ayersville Local Schools.

Payments can be dropped off ahead of time in the administration office Monday-Friday from 9 AM-2 PM to Amber Flory or checks can be mailed to Ayersville Local Schools, Attn: Jarrod Stober, 28046 Watson Rd, Defiance, OH 43512.
Payment
Should be Empty:

AHS Swim Camp Registration

Emergency Medical Form

Payment