2022 Swim Bus Registration-Deadline May 2nd or when  lessons are filled.
Swim lessons will take place Monday-Friday from June 20, 2022-July 1, 2022.
Lesson is at 9am in Tipton.
Bus will begin loading at the West Branch Public Library at 8:15am and return around 10:30am.
Lessons will be indoors!
The bus fee is $30 per person or $40 family rate payable to the City of West Branch.
All safety guidelines will be followed including mask wearing and social distancing when appropriate.
Please have your child wear a coverup or towel over their swimsuit.  They will not be changing before or after swim lessons in the locker room.
You must also register for Red Cross Swim Lessons with Tipton Aquatic Center.  There is a $40 fee for swim lessons.
Please contact Parks and Recreation Director Melissa Russell at 319-390-0393 or melissa@westbranchiowa.org for any questions.


By completing this agreement, I the participant, parent, and/or guardian under-stand that participation in this activity may result in some type of injury and protective equipment does not prevent all injuries to participants. I hereby give permission for my child, ward, or myself to participate in the below registered program and/or activity and certify that my child (or myself) is physically fit to join in the activities. I hereby waive, release, and agree not to hold the City of West Branch Parks and Recreation Department, West Branch Community School District, sponsors, supervisors, and volunteers liable for any injuries that may occur because of participation in these activities. I also give my permission for any photos/videos, etc. of these participants taken during a program to be used for future departmental promotional materials.
Please take note and govern yourself accordingly.
THE WEST BRANCH PARKS AND RECREATION DEPARTMENT AND THE CITY WEST BRANCH HAVE NO ACCIDENT INSURANCE TO PROTECT THE PARTICIPANTS

Sign in to Google to save your progress. Learn more
Email *
Parent's Name *
Phone Number *
Address *
Additional Parent's Name
Additional Parent's Phone Number
Additional Parent's Email
Child 1 Name and current grade *
Child 1 Swim Level *
Child 2 Name and current grade
Child 2 Swim Level
Clear selection
Child 3 Name and Current Grade Level
Child 3 Swim Level
Clear selection
Child 4 Name and Current Grade Level
Child 4 Swim Level
Clear selection
Child 5 Name and Grade Level
Child 5 Swim Level
Clear selection
Payment
Before continuing please pay all required fees. https://www.govpaynow.com/gps/user/plc/a001l4
Payment confirmation is required.  Please enter payment confirmation number or receipt number if payment was made in the West Branch City Office. *
Other comments
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of City of West Branch, IA. Report Abuse