Swim Lesson Registration

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Parents will be allowed inside the pool area only for lesson levels I and II. For all other levels, parents will be requested to remain outside the pool area during lessons.

* Attention: If your child does not attend for the first two weeks of swim lessons, they will be removed from the program to allow for advancement of children within the program.

Registration & Refund Policy: All program registration fees must be paid prior to the start of the program. All registrants are entitled to a full refund in the event of cancellation, or until the first day the program begins. Late entry into, withdrawal from or limited attendance in a program will not entitle any individual to a refund. All refunds under this policy will be made through the Town of Liberty's monthly voucher system.

Submitting this form certifies that the individual has permission to participate in the above designated program and you have read the Registration & Refund Policy listed above.

Email *

Parent/Guardian Name *

Address *

City, State, Zip *

Home Phone Number *

Emergency Phone Number *

Resident or Non-Resident *

Resident

Non-Resident

Child 1 *

Please include Name, Date of Birth, Age, and Swim Level.

Child 2

Please include Name, Date of Birth, Age, and Swim Level.

Child 3

Please include Name, Date of Birth, Age, and Swim Level.

Child 4

Please include Name, Date of Birth, Age, and Swim Level.

Fees *

1 Child - Resident Fee: $60 | Non-Resident Fee: $90

2 Children - Resident Fee: $80 | Non-Resident Fee: $110

3 Children - Resident Fee: $100 | Non-Resident Fee: $130

4 Children - Resident Fee: $120 | Non-Resident Fee: $150

Payment

Please mail a check payable to Town of Liberty Parks & Recreation to 119 North Main Street, Liberty, NY 12754.
Application will be finalized after a payment has been received.

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