Group Swimming Lessons WAIVER/Inquiry

Please complete this form to request more information about Group Swim Lessons (or to serve as your waiver after registration!). Please note, this is NOT the registration form. You must register your swimmer by using the appropriate link to the SignUp Genius. Thanks for your interest in our program! 

Email *
Swimmer's Full Name (first & last) *
Swimmer's Date of Birth *
MM
/
DD
/
YYYY
Has your child taken swimming lessons before?  *
What skill level is your swimmer?  *
Parent or Guardian's Full Name (first & last) *
Email Address *
Phone Number *
Do you receive texts at this number?
*only used for notifications regarding swim lessons *
Type of learn to swim lessons you are most interested in?  *

Please select all timeframes you are generally available. Exact availability will be determined if and when you are contacted by your instructor.

Mornings = before 12pm; Afternoons = 12pm - 2pm; Evenings = after 5pm


 *
Required
Please list your preferred instructor, if applicable: *
Please click yes if you will give permission to have photographs of your child taken.
 *
Please share anything you'd like us to know regarding your request for learn to swim lessons. (Previous swim experience, goals of lessons, things you'd like the instructor to focus on, anything you'd like us to be aware of, etc.)
 *
In consideration for being permitted to use the Perry Natatorium, and by checking the box below, the Registrant agrees to release the Board of Education of the Perry Local School District, its officers, agents, members, and employees (collectively referred to as, the "Releasees") in their official and individual capacities, from any and all claims, liability, or demands for damages against the Releasees for any expense, monetary damage, property damage, personal injury, sickness, illness of any nature whatsoever (including physical or emotional), or death, which may be sustained or incurred by the Registrant in connection with his/her use of the Perry Natatorium including as a result of any negligent or reckless acts or omissions of the Releasees, or any negligent, reckless, willful, or intentional acts or omissions of any other individual.  *
Lastly, if you have had lessons at Perry Natatorium previously, we'd be so grateful if you could take a few moments to write an informative review of your experience with our instructors! These reviews will be shared on our website (mention if you prefer to be kept anonymous)! 

If you have something positive to say about why you love lessons at Perry Natatorium, please share below! This is not a requirement, it would just be helpful so others considering lessons here will know why they should try us out! Thanks so much!
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