Marydell Swim Lessons 2023 Registration
Thank you for your interest in our swimming lessons!

Please note: Make-up sessions are only offered when when we have to cancel a class due to severe weather. Make up sessions will be held on Fridays. Marydell will not refund any part of the fees if the child is absent from a class.

Refund/Cancellation Policy: If you wish to withdrawal from the program, you must let us know at least three weeks prior to the start date of the session for a full refund. Any withdrawals requested after this time, but before the start of classes, will be refunded 50% of the total payment.

By completing this form you understand and agree to abide by these terms.
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Email *
Child's Name: *
Child's Date of Birth: *
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Age (5 thru 12 only): *
School: *
Grade: *
Parent/Guardian Name: *
Address: *
Home Phone Number:
Work Phone Number:
Cell Phone Number: *
Swimmer Level (refer to the image below): *
Swimming Level Guide
Which session will your child be attending? *
Who will pick up your child (name & phone number)? *
Does the child have any medical conditions we should be aware of? *
Backup emergency contacts: *
I hereby release the Executive Directors and all employees of Marydell Faith & Life Center from all claims of liability for any damages or injuries that may be sustained while my child is in the Marydell Faith & Life Center Program. *
During our programs we may take photos/videos or be photographed by the press or television. I hereby give permission for my child(ren)’s image to be used in connection with publicity, educational materials, or publications related to Marydell Faith & Life Center. I give permission for my child(ren)’s image to be used as stated above. *
Signature of Parent/Guardian (type full name): *
Date: *
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Swim Lesson Payment *
A copy of your responses will be emailed to the address you provided.
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