Session 5 Swim Lesson Registration

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August 14-25

Swimmer's Name *

Swimmer's Age *

Parent or Guardian Name? *

Parent Email? *

Parent Phone Number? *

Swim Level? *

Level 1

Level 2

Level 3

Level 4

Level 5

Parent Tot Class

Are you a member of Northwood Pool? *

Yes

I will pay for lessons with ____. *

Pool Member Pay Pal ($45 with an added convenience fee)

Non-Member Pay Pal ($55 with an added convenience fee)

Zelle ($45 member/$55 non member)

In person with a check on the first day of lessons ($45 member/$55 non member)

WAIVER OF LIABILITY: I/we assume all risks and hazards incidental to such participation and do hereby waive, release, absolve, indemnify, and hold harmless Northwood Park Swim Club and its representatives for any claim arising out of any injury to myself and/or my/our child. *

I agree

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