ParkColonyKidsSwimLessons

Cost: Members $45 and Non-Members $65 per session

Please Circle : Tues, Wed, Thurs and Fri

Session 2- July 12 to 22 And/ Or

Session 3- August 2 to Aug 12

A, C, E 10:00 to 10:45

B, C, D 10:45 to 11:30

To help us break up groups please circle one :

  1. Very beginner offered at 10:00 to 10:45
  2. Beginner who can float, kick, and go under water with assistance offered from 10:45-11:30
  3. Can float, kick, use arms and go under independently offered both times 10:00-10:45 OR 10:45-11:30
  4. Can swim some swim strokes offered 10:45 to 11:30
  5. More advanced than above offered 10:00 to 10:45

Make checks payable to ParkColony Club, Registration will only be acceptedwith Payment. Please mail registrations to:

Park Colony Club P.O.Box 21

AllenPark, MI 48101

Contact:

------ParentalWaiverandConsentForm

**ASeparateWaiverMustBeCompletedforEachChild**

Astheparentorlegalguardianofthechildnamesbelow,IherebygivemyfullconsentandapprovalformychildtoparticipateinSwimLessons.

Iunderstandthattherearecertainrisksofinjuryinherentinthepracticeandplayofthissport.Iamwillingtoassumetheserisksonbehalfofmychild.Iherebycertifythatmychildisfullycapableofparticipatingintennisandthatmychildishealthyandhasnophysicalormentaldisabilitiesthatwouldrestrictfullparticipationintheseactivities.Inadditiontogivingmyfullconsentformychild’sparticipation,Idoherebywaive,releaseandholdharmlessParkColonyClub,it’sofficers,coaches,sponsors,supervisors,andrepresentativesforanyinjurythatmaybesufferedbymychildinthenormalcourseofparticipationinswimming/tennisandtheactivitiesincidentalthereto,whethertheresultofnegligenceoranyothercause.

ChildsName:______Age______

Address:______

Phone Number:______Email:______

ParentsSignature:______

Amount paid______Received by______Date______

Check#:______Cash:______Credit Card:______