Swimming Lesson Session July 10 - July 14
This form is ONLY for Session July 10-14 11:00-11:45 Minnows and Me

Session form for June 12 –22 10:00-10:45 Jesup & 11:00 - 11:45 Readlyn/Dunkerton can be found at

Session form for July 17-July 27 Fairbank Sessions at 11:00-11:45 & 7:00pm-7:45pm can be found at

Minnows and me
Minnows and Me with a guardian is 5 classes and limited to children 2 through 3 years old. AN ADULT OR ABLE PERSON AT LEAST 14 YEARS OLD WHO WILL ASSIST IN THE WATER MUST ACCOMPANY These students as they require one on one contact to insure a safe learning environment.
Fairbank Aquatic Center Swimming Lesson Registration
By submitting this form, I give my permission for the named person(s) to take swimming lessons at the Fairbank Aquatic Center (also known as The Fairbank Municipal Swimming Pool). I release the pool personnel, Fairbank City Council, Pool Board and City of Fairbank from any responsibility in the event of an accident due to his/her own negligence, disobedience or irresponsibility, or disregard for pool and/or city rules or policies.
I understand the above statement. *
Individual Completing This Form *
Your answer
Parent or Guardian Name *
Your answer
Street *
Your answer
City *
Your answer
Phone # *
Your answer
E-Mail Address
Your answer
Emergency Contact: Name and Phone Number *
Your answer
Student 1
Student 1 First Name
Your answer
Student 1 Last Name
Your answer
Student 1 Age
Your answer
Student 1 Skill Level
Student 2
Student 2 First Name
Your answer
Student 2 Last Name
Your answer
Student 2 Age
Your answer
Student 2 Skill Level
Student 3
Student 3 First Name
Your answer
Student 3 Last Name
Your answer
Student 3 Age
Your answer
Student 3 Skill Level
Student 4
Student 4 First Name
Your answer
Student 4 Last Name
Your answer
Student 4 age
Your answer
Student 4 Skill Level
Payment Information
$15.00 for each student in Water Introduction
Total Amount Due *
Your answer
Payment Method *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms