Welcome to SwimKids Swim School!

Please enter your information and the names of each of your participating children (in the "Add New Student" section) below to sign our online waiver. Thank you!

**Please note: the "start/end dates" on this form are internal and are not the date of the party/event you are attending. This form is a general waiver for all events at SwimKids Swim School. SwimKids will NEVER sell or distribute your email address or personal information. See you at the pools!**

Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
Students entered below will be added to your family's account
Additional Information:
Lifejackets & Guardians
A responsible adult must accompany children that cannot safely swim the width of our pool. Unless a parent or guardian is with their child in the water, all participants will be given a brief swim test to determine whether or not a life jacket will be worn. SwimKids has life jackets on site to borrow. All children under age 4 must have a guardian in the water with them at all times.
I've read the above and agree.
Swim Diapers & Swim Diaper Covers
All children who are under three years of age, regardless of level of potty training, or older children who are not fully potty trained, must be double-diapered while swimming, which means they need to wear a disposable swim diaper covered by a REUSABLE snug-fitting swim diaper.
I've read the above and agree.
I understand that photographs/videos taken or posted to our Facebook page may be used by SwimKids Swim School. We never use a child's name in our marketing without the permission of their parent. **If you do NOT wish for photographs/videos of your child to be posted to our Facebook page or used by SwimKids Swim School - please let us know in the comments/questions section below.**
I've read the above and agree.
Permission to Particpate/Legal Release
To the best of my knowledge there are no physical or other conditions which will interfere with my child's participation. Safety rules are enforced. While our first priority is your child's safety, we must inform you that swimming is not risk free. As a participant or as a parent or legal guardian of a participant in a SwimKids Swim School, Inc. program,, I am fully aware that swimming can be strenuous, hazardous, and difficult. I acknowledge and freely accept the risks and hazards, including collisions, falls and risk of drowning, associated with the participation in swimming. I agree to hold SwimKids Swim School, Inc., DC Swim, Inc. DC Swim Loudoun, Inc, iSwim Inc. and its officers and agents free and harmless for any injuries or damages arising by reason of participation.
I've read the above and agree.
SwimKids Release
EMERGENCY MEDICAL RELEASE: Should a medical emergency arise during my child's participation in a Birthday Party or Open Swim at SwimKids Swim School, I understand that reasonable effort will be made to contact me. If I cannot be reached, or if it is believed that my child's life or health may be adversely affected by the delay that an attempt to contact me would cause, I consent to the administration of medical treatment and/or surgical procedures deemed necessary by the medical doctor and/or medical facility, and I consent to the immediate administration of life sustaining measures deemed necessary under the circumstances.
I've read the above and agree.
Special Conditions
Please list any special needs, concerns or medical conditions of the participant in the comment section below:
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments: