Registration
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Family Swim Night- Community Event - 3:30 -6:30 pm
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
*
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
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City:
*
State:
*
AK
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CA
CO
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DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
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ME
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NE
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NJ
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OH
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OR
PA
RI
SC
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VA
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WA
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Zip:
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Emergency Contact Info
(Not Contact #1 or #2.)
*
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Questions/Options:
How many people from your family will be attending the event? (Please include all adults and children even you do no plan to swim)
Would you like a swim assessment for your children? Swim assessments are quick one-on-one evaluations. When you arrive at the event please let us know and we will set up your evaluation.
Yes
No
Additional Information:
Sunshine Community Event
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Family swim night begins at 3:30pm and ends at 6:30pm. The lifeguard will blow the whistle at 6:20 for all participants to exit the pool. All children under the age of 3 or are not yet potty trained are required to wear swim diapers. Non-swimmers or beginning swimmers must be wear a coastguard certified life jacket and must be accompanied in the water by a guardian. Air filled floating devices are not allowed. The Sunshine Swim Center is not able to loan life vests. Sunshine Swim Center does not permit alcoholic beverages to be served on its premises or in the area surrounding the facility or recreational drugs. Glass containers of any kind are not allowed on the premises.
User agrees to indemnify and hold Sunshine Swim and Fitness Center, LLC, its agents and employees from and against any claims for damages to persons or property arising out of any use of the facility and its premises by users and their guests.
Sunshine Swim and Fitness Center assumes no responsibility for any property placed in or about the facility.
Sunshine Swim and Fitness Center reserves the right to cancel a reservation at any time.
We make every effort to provide the safest environment possible at all times. Sunshine Swim and Fitness Center rules and decisions are final.
Sunshine Swim and Fitness Center reserves the right to take and use photographs of events in marketing and promotions materials.
Note: All of the above rules and regulations are subject to change at any time.
By my eSignature verification below, I verify that I understand that electronic signatures are legally binding and have the same meaning as handwritten signatures. Pursuant to section 11.100 of Title 21 of the Code of Federal Regulations, this is to certify that I confirm that this electronic signature is to be legally binding equivalent of my handwritten signature and that the data on this form is accurate to the best of my knowledge.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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