2016-2017 Registration

Year-Round Registration form
Thank you for bringing your child to Little Sharks Swim Academy LLC. We are a SwimAmerica featured swim program. Providing swim lessons so your child can save his/her life through comfort and confidence in the water.

We are currently unable to offer every Station Level during each 30 minute class.

The Ratio for our group lessons:
1. Parent/Tot (6mo-36mo); 1 coach : 6 swimmers (with parent in the water as well)
2. Preschool - Age (3-5 yrs) Station 1-10; 1 coach : 5 swimmers
3. School - Age (6+) Station 1-6; 1 coach : 5 swimmers
4. School - Age (6+) Station 7 (Blue Group); 1 coach : 10 swimmers
5. School - Age (6+) Station 8-10 (Gold Group); 1 coach : 18 swimmers

All groups are based on developmental skill level, then age. At no time will preschool children be with school age children.

About the swimmer:
The following information provided about your swimmer. Please submit one registration form for one swimmer.
First Name:
Your answer
Last Name:
Your answer
Date of Birth:
MM
/
DD
/
YYYY
Gender:
Station Level / Experience
Little Sharks who are already enrolled, please give their Station Level. New Little Sharks, please give a brief description of the last swim level and when. If unsure, please state
Station Level
Your answer
Attending School:
Your answer
Grade:
Misc. Information:
Please make the Program Director aware of any conditions that your child my possess that we should be aware of including allergies, ear/nose/throat issues, vision, hearing, or anything that you deem necessary. Some special situations may need to be explained to our coaches to aid in the development and progress of your swimmer. We are committed in helping them to the best of their abilities.
Misc Information:
Your answer
Parent/Guardian's Information
Please provide the following information. If at anytime throughout the year you need to update your information, contact Little Sharks Swim Academy.
Parent/Guardian's Full Name:
Your answer
Address:
Your answer
City, State:
Your answer
Zip:
Your answer
Email:
Your answer
Primary phone:
Your answer
Secondary phone:
Your answer
Emergency contact:
Please provide an emergency contact. This person needs to be in the general Cedar City area.
Emergency contact name/relationship:
Your answer
Emergency contact phone:
Your answer
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