Swimming Lesson Consent Form
Participant name
First Name
Last Name
Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Birth date
-
Month
-
Day
Year
Date
Gender
Male
Female
Session beginning date and time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
How long will you participate in the lessons?
Do you have any health issues that we should be aware of?
Yes
No
Specify more details about your health condition
Your health condition report provided by your doctor
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Cancel
of
Pool equipments checklist
By signing below I agree the following
I confirm that all information given above is true.
I understand that during the session, the reaction of my child's body, cannot be predicted with accuracy, thus risks may arise due to adverse changes that may lead to heart attack, high blood pressure, or stroke.
I understand and consent to any emergency medical treatment required during the session.
I understand and agree to abide by all rules and health conditions required for use of the pool.
I understand all needed equipment given above must provide by myself, the pool does not have any authority to provide the needed equipments.
I understand and agree that no recording, filming or photographic equipment including mobile phones with camera facilities are not acceptable to using inside the pool areas.
I understand that only two excused cancellation is going to be permitted for both private and group lessons.
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