Registration
3 openings left in this event!
Already a customer? Click here to login.
Kinder (Ages 4 – 6 years) - This class teaches floating on both back and front, with both face in the water and out. Our goal is to increase the level of comfort in the water through exercises geared toward safe play, safe games, & instilling respect for others in the pool. An introduction to skills as well as to the water without a parent: Jump into the pool. Hold breath underwater for 3 seconds. Blow bubbles. Three to five bobs unassisted with blowing bubbles. Face float. Back float. Crawlstroke arms. Flutter kick. Superman glide with and without kick. (most skills start assisted and end un-assisted to pass)
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info (Not Contact #1 or #2)
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Allergies (Leave blank if NONE):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Allergies (Leave blank if NONE):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Allergies (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Allergies (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college-junior
college-senior
kindergarten
pre-K
preschool
Allergies (Leave blank if NONE):
Additional Information:
Liability Waiver
(Show-Hide Details)
By registering for a Group Swimming Lessons, you agree with the following rules, conditions and regulations and will comply with them. I am aware that this camp/class/training/event/lessons may be difficult even for a conditioned athlete. I realize that the registrant should not participate in this event unless (a) he/she is in excellent physical condition (b) has recently completed a physical exam. I hereby for myself, my heirs, my executors and administrators waive, release and discharge BKC Athletics, Inc., BKC Sports, Inc., dba Thorbeckes, and any persons connected with this program or representative, successors and assigns from any and all rights, claims or liability for damage caused by me or anyone else, arising out of or in connection with my participation. I further agree that I will defend indemnity and hold harmless BKC Athletics, Inc., BKC Sports, Inc., its members, and agenda or any of them against all claims, demands or causes of action including court costs and attorney fees directly or indirectly arising from any or other proceedings brought by or prosecuted for my benefit contrary to this agreement.
I've read the above and agree.
Payment and Refund Policy
(Show-Hide Details)
Payment is due at initial sign up. There are no refunds of dues.
I've read the above and agree.
Photo Release Form
(Show-Hide Details)
I hereby grant permission to Thorbeckes to take and use photographs and/or digital images of myself and my child to use in printed publications or materials, electronic publications (including social media), or websites.
I've read the above and agree.
Damages Waiver
(Show-Hide Details)
In the event that any damage to equipment or facilities occurs as a result of my, my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions or neglect or recklessness.
I've read the above and agree.
Non-Member Fee
(Show-Hide Details)
There will be a separate $10 (plus tax ) non-member fee that will be charged after completed registration and enrollment into the class. I acknowledge and agree to the non-member fee that will be charged. The fee will not be applied to current Thorbeckes members.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
*
Visa
Mastercard
Discover
Name as it appears on card:
*
Nickname:
Card Expiration Month:
*
01
02
03
04
05
06
07
08
09
10
11
12
Exp Year:
*
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
Address Line 1:
Address Line 2:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
*
Please Wait...