ROC Private Lessons (Minor)

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Email *

Participant Full Name *

Participant Birthdate *

YYYY

Parent/Guardian Full Name *

Parent/Guardian Phone Number *

Parent/Guardian Email Address *

Parent/Guardian Home Address *

Preferred lesson dates and times *

Any health concerns or special needs the pool staff should be aware of? *

Today's Date *

YYYY

I understand that I must pay for my private lesson at least 24 hours prior to the lesson. If payment is not made 24 hours prior to the lesson, the lesson will be cancelled. In the case that a lesson is cancelled due to inclement weather, a refund or alternative date will be provided to the participant. *

Yes

I understand that no refunds, credits, or prorations will be offered if I fail to attend my lesson. I will cooperate with all personnel, rules, and regulations. I will supervise my children so that we conduct ourselves in a polite and generous manner, clean up after ourselves, and take care not to cause any damage to the pool facilities. I will promptly report any observed damage, malfunction, or cleanliness shortcomings to the pool staff. I will read and sign the hold harmless agreement provided by the pool staff prior to the first lesson. *

Yes

A copy of your responses will be emailed to the address you provided.

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