Select Swim Academy Registration Form
Welcome to Select Swim Academy!
Enroll your child in a high quality swimming program! Select Swim offers several programs in accordance with your child's needs. Please fill out a separate registration for each child! Please put in your child's info and answer the questions to reserve your spot.
How did you hear about us?
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Please fill out your contact information
Address
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Name
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ZIP
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Country
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State
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City
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Phone Number
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Email
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Your child's first and last name
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Emergency Contact person and phone number
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Your child's information
Birthday
MM
/
DD
/
YYYY
Allergies
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Disabilities
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Special Needs
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Primary Doctor
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Medications
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Skill Notes
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Health Insurance Carrier
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Times Available
Program Schedules
- Group Lessons are available on

Saturday 4:00-4:30p.m., 4:30-5:00p.m.

- Stroke Clinic is available on

Saturdays 4:00-5:00p.m., 5:00-6:00p.m., 6:00-7:00p.m.

Sunday 7:00-8:00p.m.

- Summer League Supplemental Program is available on

Saturdays 4:00-5:00p.m., 5:00-6:00p.m., 6:00-7:00p.m.
Sundays 7:00-8:00p.m.

- Elite Swimmers Enhancement Program is available on

Sundays 7:00-8:00p.m.

- Private lessons are per request

(please contact office for scheduling)

Which program do you want to enroll?
Please select the program you would like to enroll your child
Please pick the days and times for the program you would like to enroll.
4:00-4:30pm
4:30-5:00pm
5:00-6:00pm
6:00-7:00pm
7:00-8:00pm
5:00-5:30pm
5:30-6:00pm
10:00-11:00am
Saturday
Sunday
Sessions
1. Year- Round Programs

Stroke Clinic, Summer League Supplemental Program and Elite Swimmer programs run from January 20, 2018 to May 6, 2018.


2. Group lessons are offered for those swimmers who are just being introduced to the swimming world in three eight-week sessions.

1st session: Oct 21, 2017 - Dec 16, 2017

2nd session: Jan 6, 2018 - Feb 24, 2018

3rd session: Mar 3, 2018 - Apr 28, 2018

3. Private Lessons

4. Summer Swimming Clinic

Select your Program
Paying by
Policies
Annual Administrative Fee
The annual registration fee applies to each swimmer registered in all of our programs. This fee is due at the beginning of each program.
Make Up
In order to maintain high standards of customer expectations and to preserve the integrity of our programs, we do not provide make ups, except lessons missed due to the facility being closed for public holidays or inclement weather conditions.
Swim Diapers
All children under the age of 3 or any child not yet fully potty trained are required to wear both a disposable and a waterproof, reusable diaper. Please make sure you are buying a reusable diaper that is not too big for your child.
Cancellation and Withdrawal
A full refund except for the registration fee will be issued for cancellations made 7 days prior to all our programs. After that withdrawals will be pro-rated. No refund on registration fee. Please contact the office via email at select.swim@gmail.com for further information
Facility Policies and Rules
Sign in at the front desk of the facility. No swimming after the class time. All pool rules posted at the facility applies to all Select Swim swimmers.
Program Fees
Liability Release
In consideration of my child’s participation in the Select Swimming swim program, I, intending to be legally bound, hereby for myself, children, heirs, executor, administrators and assigns waive, release, and forever discharge any and all rights and claims against Select Swimming for damages which may be sustained or suffered by my children while participating or traveling to or from participation in any and all activities of Select Swimming, including, but not limited to swim sessions, social activities, and meetings.
Photo Use Agreement
I hereby grant, voluntarily and with full understanding, to Select Swimming a license to the following: 1. Use and storage of my name and my child’s and image, by means of digital or film photography, video photography, audio recording or other documentation, with respect to the activity, namely Select Swimming, swim lessons. 2. Use of any stored data including my name and image in printed publications of Select Swimming. 3. Use of any stored data including my name and image in electronic publications of Select Swimming. 4. Use of any stored data including my name and image in any Web site created by or for Select Swimming for its sole benefit. 5. If I am signing this agreement on behalf of a minor child, I hereby warrant that I am the legal parent or guardian of the child and that I have the legal authority to sign this agreement on behalf of the child.
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