SCC Summer School 2021: Swimming Lessons Sign Up
SCC swimming lessons will run Monday to Friday, July 19 through July 30.  Lessons this year will again be held at the Ellsworth Klaas-Jonas Community Pool.  Please fill this form out for each student that will be attending lessons.

If you have additional questions or need help selecting your child's swimming lesson level, please refer to the Klaas-Jonas Pool’s website: https://www.ellsworth.k12.wi.us/community/helpful-hints.cfm (scroll down to the “Swimming Lesson Levels” section)
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name *
Male or Female? *
Grade Level (for this coming Fall, the 2022-2023 school year) *
Class Level (Ellsworth will offer all 6 of their levels for our summer lessons) *
First Choice for Time Slot *
Second Choice for Time Slot *
Third Choice for Time Slot *
Transportation TO Ellsworth *
Transportation FROM Ellsworth *
*Special Consideration* request - only mark this question YES if you plan to transport your child to and from Ellsworth *
Parent Name *
Parent Phone Number (Best number to call) *
Please list any other email addresses you'd like us to copy on future swim lesson communications
By checking yes, you understand that in the event that your child needs immediate medical attention for injuries received while participating in swimming lessons, I authorize Klass-Jonas Community Pool staff to give my child reasonable first aid, and to arrange transport of my child to a health care facility for emergency services as needed.  I hereby acknowledge that staff will assume that either parent of my child may pick up my child at any time during the program unless there is pertinent court documentation that indicates otherwise. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of SCC. Report Abuse