2017 Adult Learn to Swim Program

Koon’s Memorial Park Pool

P.O. Box 6095, Harrisburg, PA 17112

Phone 717-657-8452 Email Web www.koonspool.com

Dates: July 10 – July 21 Evenings

Times: Beginner 4:30-5:10

Intermediate/Advanced 5:20-6:00 pm

Cost: $20.00 per person Cash or Check Make payable to Koon’s Pool

Which level should I register: never taken swimming lessons but, can swim 10 ft on front & back unassisted register for some ability.

What to wear: bathing suit, NO Goggles. Bring a towel and sweats or a cover-up in case of cool weather. Secure long hair and remove jewelry before coming to the pool. We are NOT responsible for items left in the locker room or pool area.

Severe weather: listen to WINK 104 for cancellations

All spectators must wait outside the pool area! due to liability for the pool and Red Cross only water safety instructors, students and assigned volunteers will be permitted in the pool area once classes have begun. Please note that all water safety instructors are volunteers. Please be respectful.

Please keep this page for your records.

E-mail completed Registration to:

Thank you

Management

2017 Adult Learn to Swim Registration

Koon’s Memorial Park Pool

P.O. Box 6095, Harrisburg, PA 17112 717-657-8452

Dates: July 10 – July 21 Evenings

Times: Beginner 4:30-5:10

Intermediate/Advanced 5:20-6:00 pm

Please PRINT all entries:

Name: ______Age: ______Gender: M F

Address: ______

Phone: ______E-mail: ______

Health Information or Special Needs Instructors should know?

______

Cost $20.00 per person Cash: _____ Check: _____ Make payable to Koon’s Pool

Please register me for Aquatics: Beginner ______Intermediate______Advanced ______

EMERGENCY CONTACT, in case of an emergency:

Name: ______Relationship: ______Phone: ______

I, the undersigned, give consent to have the above named person enter the 2017 American Red Cross Adult Learn to Swim Program offered at Koon’s Memorial Pool. I understand that cooperating authorities and owners of the swimming area will not be responsible for loss of property, injury or death due to accident.

Signature: ______Date: ______

**For your safety and to reduce confusion – ALL Persons are asked to leave the swimming area after you are checked in. they are welcome to stand by the fence outside the pool to observe. **

E-mail completed Registration to:

Thank you

Management