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Lifeguard Original Class 1/2022
Please fill this out so I can start the online portion of the class and email you all the information you will need for the class. Any questions please email
flanaganflyers@gmail.com
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Email
*
Your email
Name
*
Your answer
Age
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Phone Number
*
Your answer
email address (of the person taking the lifeguard class)
*
Your answer
$80.00 Deposit Paid (can drop off at the Flanagan Memorial Pool attn: lifeguard class or Mail it to the pool 204 E Falcon Highway Flanagan, IL 61740)
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Cash
Check
N/A
OWES
Check number
Your answer
$160 Full Amount paid (can drop off at the Flanagan Memorial Pool attn: lifeguard class or Mail it to the pool 204 E Falcon Highway Flanagan, IL 61740)
*
Cash
Check
N/A
OWES
Check Number
Your answer
Any other concerns or things the instructor should be aware of?
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Your answer
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