Backyard Pool Registration
Email address *
Pool Owner's Name *
Your answer
Parent Name *
Your answer
Parent Phone Number *
Your answer
Name of Swimmer 1 *
Your answer
Age of Swimmer 1 *
Your answer
Swim Level (select one) *
Name of Swimmer 2
Your answer
Age of Swimmer 2
Your answer
Swim Level (select one)
Name of Swimmer 3
Your answer
Age of Swimmer 3
Your answer
Swim Level (select one)
Minor Waiver/Photo Release: I, the parent or guardian of the above named participant, hereby give my approval for my child to participate in any and all activities associated with the YMCA Summer Recreation program. In addition, I give my permission for the Muskegon YMCA and its partners to use any photos of my child for the purpose of the promotion of the YMCA Summer Recreation Program and for future funding. I know and understand that program participation might result in serious injuries and do hereby waive, release, absolve and agree to hold harmless the Muskegon YMCA, the partners, the organizers, sponsors, supervisors, and participants from any claim of liability. NOTE: A participant will not be registered unless a signed form is returned to the Muskegon YMCA. By typing my name in the box below, I agree to the above terms and condiditons. (Please type name and date in the answer box below.) *
Your answer
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