2018 Swimming Lessons Registration
Cuyahoga Heights Village Pool
pool@cuyahogaheights.com
(216)341-7684

*Payment will be accepted once the pool opens Please make checks payable to:
Cuyahoga Heights Village

(A pool pass must be purchased prior to participating in swimming lessons)

First Name of Child (One child per form please) *
Your answer
Last Name of Child *
Your answer
Age *
Parent/Guardian Name *
Your answer
Parent/Guardian Address *
Your answer
Parent/Guardian Phone #1 *
Your answer
Parent/Guardian Phone #2
Your answer
Parent/Guardian Email #1
Your answer
Parent/Guardian Email #2
Your answer
Highest Swim Level child has passed: *
Swim Session Dates *
Required
Choose Swim Level & Days (Choose only one) *
Required
Small Beginner / Session 1: June 11-June 29 (Choose only one. Four spots available each half hour.)
M / T/ W /Th / F
M / W / F
S
10:30
11:00
11:30
12:00
Small Beginner / Session 2: July 2-July 20 (Choose only one. Four spots available each half hour.)
M / T/ W /Th / F
M / W / F
S
10:30
11:00
11:30
12:00
Small Beginner / Session 3: July 23-August 10 (Choose only one. Four spots available each half hour.)
M / T/ W /Th / F
M / W / F
S
10:30
11:00
11:30
12:00
Agreement, Waiver, and Release *
Required
Submit
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