JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
I pledge to be a WATER WATCHER!
By completing the WATER WATCHER pledge, you are agreeing that YOU will take RESPONSIBILITY to keep kids safe in and around water!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I agree to ACTIVELY WATCH children in and around the water.
*
Yes
I agree to KEEP my eyes on the water.
*
Yes
I agree to AVOID distractions like talking on the phone, socializing or reading while watching children.
*
Yes
I agree to KEEP a phone near water for emergencies.
*
Yes
I agree to REMAIN by the water until relieved by a new WATER WATCHER.
*
Yes
I agree to CHECK the temperature and strength of currents in natural bodies of water before allowing children to be in the water and/or swim.
*
Yes
I agree to USE a well-fitting life jacket for children on boats.
*
Yes
I agree to be a RESPONSIBLE WATER WATCHER!
*
Yes
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zipcode
*
Your answer
I pledge to be a Water Watcher!
Your pledge will help kids stay SAFE around water!
If you have any questions or would like any additional information, please email
sabrina@eugeneymca.org
.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Eugene Family YMCA.
Report Abuse
Forms
