Registration Form
Course takes place at the Neepawa Swimming Pool - 418 Davidson Street 
  • August 9 - 5:00pm-9:00pm
  • August 10 - 9:00am - 5:30pm
  • ​August 11 - 9:00am - 5:30pm
​$350.00 per candidate
​Includes all course materials and certification costs. 

Prerequisites:  
      - 15 years of age by the last day of the course
      - Bronze Cross Certificate 
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Candidate First Name: *
Candidate Last Name: *
Candidate Birthdate:  *
Email: *
Phone: *
Medical Numbers (6 digit, 9 digit) *
Emergency Contact Name: *
Emergency Contact Phone Number: *
Candidate is 15 years or older by August 11, 2024? *
Required
Payment Information:
Registration payment is due upon submitting this registration form.

Payments can be made in the following ways:
1. E-transfer to accounts@neepawa.ca - Include Name and Swim for Life Course
2. Credit Card - by calling 204.476.7600
3. In Person at the Town Office 275 Hamilton Street, Neepawa MB
QUESTIONS? CALL 204.476.7614 or EMAIL recreation@neepawa.ca
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