Honesdale Borough Pool – Swim Lessons Registration Form

Honesdale Borough Pool – Swim Lessons Registration Form
Please complete this form to register your child for swim lessons at the Honesdale Borough Pool.
Swim lessons will be held on Mondays,
Wednesdays, and Fridays in 30-minute blocks:
- ➤ 9:00am – 9:30am
- 9:30am – 10:00am
- 10:00am – 10:30am
- 10:30am – 11:00am
- 11:00am – 11:30am
Borough Residents:
- $20 per lesson
- $230 per month
Non-Residents:
- $25 per lesson
- $290 per month
Pricing (Payment will be collected on the first
day of swim lessons)
Important Policies
- Swim lessons will be held weather permitting. Weather-related cancellations are not refundable but your lesson fee can be redeemed for a later date.
- If your child cannot attend a lesson, cancellations must be made at least 48 hours in advance to receive a refund for that lesson.
- Children must be at least 3 years old at the time lessons begin.
- If your child has a fever, they may not attend swim lessons.
Participant Information
Swimmer's Name:
Date of Birth:

MonthDayYear
Date
Age:
Parent/Guardian Name:
Email Address:
example@example.com
Phone Number:
Format: (000) 000-0000.
Home Address:
Emergency Contact Information
Emergency Contact #1
Name:
Relationship:
Phone Number:
Format: (000) 000-0000.
Emergency Contact #2
Name:
Relationship:
Phone Number:
Format: (000) 000-0000.