Swim Stars - Waiver and Release of Liability
PLEASE NOTE, THIS FORM NEEDS TO BE SUBMITTED ONCE FOR EACH CHILD.

PLEASE READ CAREFULLY BEFORE SIGNING. THIS IS A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS.
Email address *
Your Swim Stars Enrollment Card ID Number: (see picture below) *
Your answer
Your Swim Stars Enrollment Card ID Number can be found here:
I, (signed below parent/guardian of the participant) agree and understand that swimming is a HAZARDOUS activity. I recognize that there are risks inherent in the sport of swimming, including but not limited to, paralyzing injuries and death. The participant hereby agrees to participate in swim lessons, swim classes, swim practices etc. and hereby agrees to indemnify and hold harmless Swim Stars LLC, its coaches, instructors, officers, directors, agents and employees against any liability resulting from any injury that may occur to the participant while participating in swim lessons. The participant also agrees to indemnify Swim Stars LLC for any damages incurred arising from any claims, demand, action or cause of action by the participant. The participant authorizes any representative of Swim Stars LLC to have the participant treated in any medical emergency during their participation in swim lessons. Further, the participant and/or parent/guardian agrees to pay all costs not covered with medical insurance. I have noted on the back of this form any medical/health problems of which the staff should be aware. I HAVE CAREFULLY READ THE ABOVE LIABILITY RELEASE AND SIGN IT WITH FULL KNOWLEDGE OF ITS CONTENTS AND SIGNIFICANCE. *
Parent's or Legal Guardian Digital Signature: *
Your answer
Signed on: *
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Participant Information
Please Enter child's information below
Child's full name: *
Your answer
In case of an emergency, please notify: (name and phone number) *
Your answer
Does the participant have any physical or mental disabilities that staff should be aware of for instructional modifications or emergency purpose? *
If yes, please explain:
Your answer
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