SVOR JUNIOR LIFEGUARD & CADET PROGRAM AGES 14 - 16 - Coopers Beach 2023
TO ENROLL IN THE JUNIOR LIFEGUARD PROGRAM for AGES 14 & 16

PLEASE FILL OUT THIS FORM
Maximum:  30 participants 
The remainder will be waitlisted
You will be notified automatically by email if you are waitlisted

PLEASE FILL OUT A SEPARATE FORM FOR EACH CHILD

*If you enroll and your plans change please email us at
SVOceanRescue@gmail.com with "Junior Lifeguard Program" in the subject

PRE-TEST EVALUATION DATE
  • Pool Test prior - Pre-test Evaluation (location & date will be announced shortly)
JUNIOR LIFEGUARD & CADET PROGRAM DATES: (Saturdays 8:30AM-10:30AM)
  • July 8
  • July 15 
  • July 22
  • July 29
  • August 5 

COST: $60 (ages 14 - 16) 

Please make all checks payable to the "Village of Southampton" with 
"SVOR Junior Program " or "SVOR Cadet Program 2023" in the memo section
Payment Due after the pool test is complete or on the first day of the course
      
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Email *
JUNIOR LIFEGUARD PROGRAM for AGES 14 & 16 
Age at the time course starts:
(8:30AM - 10:30AM)
 *
Required
CHILD'S NAME (first & last) *
PARENT 1 NAME (first & last) *
CELL PHONE (Parent 1) *
EMAIL ADDRESS (Parent 1)  we won't share your info with any 3rd parties and we won't send you junk mail. *
PARENT 2 NAME (first & last) or Alternative Emergency Contact & relation to participant
 *
CELL PHONE (Parent 2 - if applicable) - or alternative Emergency Contact Phone Number
 *
EMAIL ADDRESS (Parent 2)  we won't share your info with any 3rd parties and we won't send you junk mail.
CAREGIVER'S NAME (first & last) & any relative or friend that may be picking up your child
CELL PHONE (Caregiver(s) or Relative(s)
Please make sure it's clear which name goes with which phone number
Local Street Address (full address) *
Child's T-shirt Size
Clear selection
Please list any special skills your child has as far as competition games - fast swimmer, runner, beach flags 
Thanks!
Please list any medical conditions that your child has - and any medication that they need to have with them
Submit
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