Registration
1 openings left in this event!
Already a customer? Click here to login.
Come and join us for an exciting EGG HUNT in the pool! It's a splashing good time in our heated indoor swimming pool. We will have snacks, drinks, crafts, and PRIZES! $25 per child Parents accompany their child for free. If parent would like to swim, it is $10 per adult.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Guardian Information
First Name:
*
Last Name:
*
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:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Photo Release? Yes/No:
*
First time in Swim Lessons? :
*
Can they swim independently?:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Photo Release? Yes/No:
*
First time in Swim Lessons? :
*
Can they swim independently?:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Photo Release? Yes/No:
*
First time in Swim Lessons? :
*
Can they swim independently?:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Photo Release? Yes/No:
*
First time in Swim Lessons? :
*
Can they swim independently?:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Photo Release? Yes/No:
*
First time in Swim Lessons? :
*
Can they swim independently?:
*
Questions/Options:
Does your child have any allergies? If yes, please describe.
*
Do you allow your child's photo to be taken for our event photo album?
*
Yes
No
Additional Information:
NO REFUNDS
(Show-Hide Details)
No refunds will be issued for any reason. This includes, but is not limited to: family vacations, religious holidays, schedule changes in other activities, illness/injury, illness/injury of a family member, bad weather, parties, sporting events, etc. If you do not attend the event, refund or credit will not be issued.
I've read the above and agree.
CODE OF CONDUCT
(Show-Hide Details)
All persons on premises are required to conduct themselves appropriately. This includes, but is not limited to, swim students in the pool, children outside the pool, and parents/guardians, whether in the pool, in the pool area, or in the locker rooms. Children are not permitted in the pool unless supervised by an instructor. Running, throwing, yelling, biting, hitting, and other disruptive behavior is not permitted. Children not following this code will be asked to sit out. If disruptive behavior continues, the parent will be asked to pick up their child immediately and all fees paid will be forfeited. There are no exceptions to this policy
I've read the above and agree.
WAIVER
(Show-Hide Details)
I, the enrolled participant and/or parent/legal guardian of the participant agree and understand that swimming is a HAZARDOUS activity. I also recognize that there are risks inherent in the sport of swimming including but not limited to paralyzing injuries and death.
The participant and/or parent/legal guardian of the participant hereby agrees to participate in the swim lessons and other aquatic activities and hereby agrees to indemnify and hold harmless FIVE STAR FITNESS & AQUATICS LLC. its instructors, coaches, managers and employees against any liability resulting from injuries that may occur to the participant while participating in swim lessons and other aquatic activities. The participant and/or parent/legal guardian of the participant also agrees to indemnify FIVE STAR FITNESS & AQUATICS LLC. for any damages incurred arising from any claims, demands, action or cause of action by participant.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
Visa
Mastercard
Amex
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...
