Parker Pool Swim Lesson Registration Form
Please fill out the below form to sign up for swim lessons with Parker Pool Summer of 2017.
Please describe how your swimmer swims now:
Sessions (Exact times for half hour lessons will be emailed.)
June 19 - 29 AM Session 9am - 11 am
June 19 - 29 PM Session 6pm - 7pm
July 3 - 13 AM Session 9am - 11am
July 3 - 13 PM session 6pm - 7pm
July 17 - 27 AM session 9am - 11am
July 17 - 27 PM session 6pm - 7pm
July 31 - August 10 AM session 9am - 111am
July 31 - August 10 PM session 6pm - 7pm
August 14 - 24 AM session 9am - 11am
August 14 - 24 PM session 6pm - 7pm
Group lessons are $40 paid by cash or check delivered to the pool by the Friday prior. The fee is $41.20 if paying by PayPal.
I will be paying by cash or check delivered to the pool
I will send my payment through PayPal to
I selected private swim lessons for my swimmer
Does this swimmer have any allergies?
Please share any special needs or information that would be beneficial for us to know about the child:
I understand the inherent risk of injury involved in participation in this sports program and verify that my child is medically fit to participate. I give my permission to the supervisors of this program to take the proper steps in case my child is in need of emergency medical attention. I also release the sponsoring groups and their agents from any and all claims arising from this child's participation in this activity.
I accept the risk
I grant the right to Parker Pool Management to take videos of me and parties to which I am legal guardian to use such video for any lawful purpose, including publicity, illustration, advertising, social media and web content. Participant or Parent/Guardian of the Participant(s) understands that photos and video are occasionally taken for promotional and marketing purposes.
Yes, I grant this right to Parker Pool Management
Classes will be set up the Friday morning prior to start date so please check your email for your exact lesson time. Please offer any comments, suggestions, or concerns. Thank you for your support!
Send me a copy of my responses.
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