Hayfield Farm Red Cross Lifeguard Training 2021
By signing up for this class I acknowledge that I am at least 15 years of age and agree to pay the full cost of the course by June 5th.

Class Cost:
Initial Certification: $295
Recertification: $270

Initial Certification: June 5th 7:00 AM-12:00 PM and June 6th 7:00 AM-12:00 PM at Hayfield Farm
Recertification: June 5th 7:00 AM -12:00 PM at Hayfield Farm

Payment is due prior to the start of class on June 5th. Payment may be hand delivered to the class or mailed to the address below. If paying by check, please include the student name in the memo.

The online portion must be completed before class begins on June 5th. If you do not complete the online portion of the class you cannot continue and and we will issue a 50% refund on the course.

After completing this form, you will receive a link from the Red Cross to complete the required online training. All online trainings must be completed prior to our in person sessions on June 5th. Please email the instructor your completion certification or print and bring it to the in person session.


Instructor Information:
Jackie White
Flutterjax@gmail.com
703-655-8882

Payment Address:
J and M Swim, LLC.
c/o Matt Murray
7018 Clifton Knoll Ct
Alexandria VA 22315
(cash or check made out to "J and M swim, LLC.").

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First and Last name *
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I will attend on the date below: *
By completing this form, I agree to pay the full cost of the class and complete the required online portions before attending in person.
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I will be at least 15 years old by the first day of in person instruction.
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