SAW - Macon

Safety Around Water- Registration Form

For generations staying safe around water meant keeping kids away from water, but it’s time to start a new family tradition. Safety Around Water is a great starting point to get kids comfortable and confident in the water. In partnership with Macon-Bibb County and Representative Tangie Herring, the YMCA of Metro Atlanta is offering FREE Safety Around Water Swim lessons for kids ages 6 - 12 on July 27th - July 31st at the South Bibb Recreation Center (7035 Houston Road, Macon, GA 31216) This program is designed to engage, educate and teach youth the skills they need to be safe  in the water. We are offering these classes to the Macon-Bibb community at no charge.
Swimmers Name

First NameLast Name
Swimmers Birth Date

MonthDayYear
Swimmers Gender
Swimmers Age
Parent or guardians Name

First NameLast Name
Parent or guardians Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent or guardians Email
example@example.com
Parent or guardians Phone Number
Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Emergency Phone Number
Format: (000) 000-0000.
Has the swimmer taken lessons before? If your swimmer has had lessons before put NO. If your swimmer has had lessons explain where and what was taught.
Current swim ability?
Fear of water?
Additional Comments
YMCA PHOTO/AUDIO VISUAL/NARRATIVE RELEASE
Release from Liability. I agree that my consent is irrevocable. I hereby release and discharge the YMCA or Metro Atlanta and collaborating third-parties, from any and all claims, actions, lawsuits or demands of any kind arising out of my consent, license grants, uses, or the shared uses of any works or materials referenced herein.
Should be Empty:

Safety Around Water- Registration Form

YMCA PHOTO/AUDIO VISUAL/NARRATIVE RELEASE