Registration
Welcome to SwimKids!
The form below may be used to sign a SwimKids Event Waiver OR to register for Swim Lessons/Stealth.
Waivers for SwimKids Events (such as Stealth Dive Clinics and Bring-A-Friend events) have NO FEES.
If registering for classes you will receive an email shortly from
noreply@jackrabbittech.com
with a copy of your signed waiver, confirmation of your Class Time, and the words "Click here to access your Parent Portal" at the very top. This email is sent automatically for all online registrations and IS NOT YOUR YOUR TOTAL AMOUNT DUE.
Once we've reviewed your registration, you will receive a SECOND confirmation email from
@swimkids.us
detailing all fees, discounts, and the total amount being charged to your card.
For year-round classes, the fee information in the "Enrollment Confirmation" auto-sent email IS NOT YOUR TOTAL AMOUNT DUE because it does not include tuition for next month, and we bill one month in advance.
Example: on June 1, fees are posted and paid for July tuition. On July 1, fees are posted and paid for August tuition.
When you register for year-round classes your up-front fees will include your annual registration fee (if due), tuition for the month you start (prorated as needed), AND tuition for next month
(because we bill one month advance).
If you sign up to start year-round lessons AFTER tuition has been posted for that month, we will post those fees at the time you sign up. The email the system auto-sends for online registrations is not "smart enough" to know to include next month's tuition (or to apply discounts). We have to post those manually after you sign up,
which is why we'll send you a
SECOND
confirmation email.
If you have any questions, please don't hesitate to contact us at (703) 396-7946.
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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!**
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Father
Grandparent
Guardian
Mother
Other
Parent
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
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)
Disabilities (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (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):
Medications (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):
Medications (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):
Medications (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):
Medications (Leave blank if NONE):
Additional Information:
Lifejackets & Guardians
(Show-Hide Details)
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
(Show-Hide Details)
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 TWO snug-fitting reusable swim diapers, or a disposable swim diaper covered by a snug-fitting reusable swim diaper.
I've read the above and agree.
Photographs
(Show-Hide Details)
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
(Show-Hide Details)
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
(Show-Hide Details)
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
(Show-Hide Details)
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:
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