2019 Calmar Pool Private Lessons
Please fill out the form below to sign up for private lessons at the Calmar Pool this summer! Once you fill out a form, we will do our best to line you up with a lifeguard who will then reach out to you to schedule times/ dates for the private lessons. All private lesson payments go directly to the guards. DEADLINE FOR ALL PRIVATE LESSONS IS JULY 24th!!
Email address *
Name of Participant
Age of Participant
Have taken lessons before? If so, how many years? *
Parent/ Guardian Name
Parent/ Guardian Phone Number *
Please list emergency contact and phone number
Permission, Release and Emergency Treatment: As a parent and/or guardian of the minor child(ren) listed above, I grant permission to participate in private lessons at the Calmar Pool. By granting permission I hereby acknowledge that the risk of injury, which could lead to permanent disability, or even death, is inherent in any athletic activity. Furthermore, I understand that the possibility of a catastrophic injury does exist even though the proper rules and techniques are followed to the fullest.I hereby assume such risks of injury on behalf of my child(ren) and myself and will not hold the City of Calmar, lifeguard instructors, volunteers or funders responsible for accidents taking place during practice or sponsored meets/ activities.I hereby authorize treatment by a qualified and licensed medical doctor in the event of a medical emergency which, in the opinion of the attending physician, may endanger his/her life cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after reasonable effort has been made to contact me. Furthermore, I accept all financial responsibilities for necessary treatment and services.
Clear selection
Please Check That Apply
By checking this box, you agree to all the information above and hereby agree to have this check mark be validated as your written signature.
Please list any preferred guard you may have. (We cannot guarantee you will match, but we will do our best) *
Please list any other information about the swimmer that we may need to know about (allergies, medication, etc) *
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