Funded by the 21st CCLC Program

Administered by the US Department of Education

Name of Student ______Camp Site: ______

Swimming

Swimming is one of the optional activities available to children for students at Camp ACE. Students are supervised by the on duty lifeguards on site as well as the Camp ACE staff. Camp ACE Staff may be in the water with the children during swim time. We take safety seriously and students will be expected to follow the pool rules and Camp ACE safety rules at all times, which include no diving, running or horseplay.

Please check below giving permission for your child to participate/or not participate in this activity:

1. ______My child has permission to participate in Camp ACE swimming activities.

2. ______My child can swim.

If YES, please indicate child’s swimming ability:

______“Beginning Swimmer”

______“Non Swimmer”

Beginning Swimmer means a child who has mastered the skills required to:
(A) Hold his breath with his head submerged;
(B) Perform a front and back float;
(C) Perform the flutter kick on this front and back;
(D) Be able to level off from a vertical entry into a float position; and
(E) Do a combined stroke (front or back) for at least 20 feet without stopping.
Non Swimmer means:
(A)a child who does not meet the definition of “Beginning Swimmer”.

______My child does nothave permission to participate in swimming activities. I understand my child will remain onsite at camp and join another group close to his/her age group for an alternate activity.

I understand that ACE may take my child to a local public swimming pool. ACE does not employ the lifeguards, swimming pool operators, or swimming pool managers. ACE is not the owner or the operator of the swimming facility. Consequently, I agree to waive all causes of action, claims, damages, demands, expense, liabilities that I and my family may have against Camp ACE arising out of any swimming activity. I further agree that in no event shall ACE, its managers, officers, or employees be liable for any claim, cause of action, damage, demand, expense, fine, liability, or penalty arising out of any swimming activity. The term “swimming activity” shall mean swimming in the pool, wading in the pool, playing in the pool, diving into the pool, jumping in the pool, as well as any activity occurring on the pool deck and on the pool’s property.

I further agree to defend, hold harmless and indemnify ACE and its managers, officers from any claim, cause of action, damage, demand, expense, fine, liability or penalty arising out of my child’s inability to swim, if I have checked item no. 1 above, or item no. 2 above.

This waiver along with the Camp ACE Registration Form constitute the entire agreement of the parties and supersedes all prior written or oral agreements.

Print Name ______Parent Signature ______

Date ______