2019 Registration Form- Beacon Hill Pool
Please complete the information below and submit your payment to complete your registration for summer 2019.

See you Poolside!
Family Name *
Your answer
Membership Package **Note Membership will not be confirmed until payment is received** *
Street Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Primary Phone # *
Your answer
Secondary Phone #
Your answer
Email Address (strongly recommended as primary communication method)
Your answer
Emergency Contact Full Name *
Your answer
Emergency Contact Phone Number *
Your answer
New or Existing Member ? *
Bronze Medallion and Bronze Cross Lifesaving Courses
**Please complete the separate Online Course Registration form for each particpant**

6pm-8:30pm (medallion) and 6pm-9:00pm (cross), Tuesdays, June 25 to August 20

Bronze Medallion Prerequisites:
(1) min. 13 yrs. old OR hold Bronze Star certification
(2) completed Red Cross Swim Kids 10, Olympic Way Silver, or equivalent
(3) must provide a photocopy of my certification card (Bronze Star) OR photocopy of my Medicare card/Gov’t ID as proof of age (to be provided at a later time)
(4) must pay the $55 course fee

Bronze Cross Prerequisites:
(1) Bronze Medallion
(2) must provide a photocopy of my Bronze Medallion certification card
(3) must pay the $55 course fee
Activities and lessons
* In addition to swimming lessons, the following programs are available, and NO PREREGISTRATION IS REQUIRED:
Mom’s and tots, Water polo, Synchro and Diving lessons are held during morning lessons and are open to anyone who wants to attend. Please see lifeguards a few days prior to the beginning of the lesson session for availability.

* Adults can attend aqua-fit held during morning lessons (check the lesson board for time) and can attend stroke improvement/master conditioning workouts (Tuesday,Thursday 8-9pm and Saturdays 5-6pm).
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