Registration
3 openings left in this event!
Our Home School Open Swim Program is designed to fit your needs as a home school household giving your children an opportunity to gather with children of the same age to come together and enjoy a day of recreational swimming, and most importantly have fun! Let your children spend time with other home school children in an inclusive, positive and engaging environment!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Type
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Father
Grandparent
Guardian
Mother
Other
Parent
Step Parent
Student
Home Phone:
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Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
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City:
*
State:
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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
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SC
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WA
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WV
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
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)
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)
Allergies (Leave blank if NONE):
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
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)
Allergies (Leave blank if NONE):
Additional Information:
Assumption of Risk & Release of Liability
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I, the enrolled participant and/or the parent/guardian of the participant agree and understand that swimming is a hazardous activity. I recognize that there are risks inherent in the sport of swimming, including but limited to paralyzing injuries and death. As the legal parent or guardian, I release and hold harmless The Swim People,LLC, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of The Swim People, LLC, its owners and operators or in route to or from any of said premises. The participant also agrees to indemnify The Swim People, LLC for any damages incurred arising from any claims, demand, action or cause of action by the participant.
The participant authorizes any representative of The Swim People, LLC to have the participant treated in any medical emergency during their participation in the program. Further, the participant and/or parent/guardian agree to pay all costs associated with medical care and transportation for the participant. I have noted any medical/health problems of which the staff should be aware. I have carefully read the above liability release and sign it with full knowledge of its contents and significance.
I've read the above and agree.
Fees
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I understand that due to operational costs the program fee is non-refundable unless there is a pool closure beyond our control. Payment is due at the time of registration to secure reservation.
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:
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Exp Year:
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2024
2025
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2031
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2033
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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:
*
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