The Gym Swim Lesson Registration
Participant Registration Form
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Email *
First Name *
Last Name *
Street Address *
City *
State *
Zip Code *
Phone number
Date of Birth *
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Parent/Guardian Name (if participant is under 18)
By completing this form, I am registering for swim lessons with THE GYM HSV. I agree to pay the $25 non-refundable registration fee and the separate additional cost for swim lessons.  I am aware that I must schedule lessons separately from this form. *
Lesson Session *
If you are interested in our Adaptive Swimming Lesson, please indicate your special needs here, to help us better prepare for your lessons. You may also email us at thegymhsv@gmail.com
Cancellation Policy: We must be notified of cancellation 24 hours in advance of scheduled sessions. You must receive confirmation of cancellation. If you do not appear for a scheduled appointment or fail to give 24 hour notice, you will be charged for the full session. Cancellations made with appropriate notice will be rescheduled. *
MEDIA RELEASE: THE GYM HSV regularly uses photos and video in its publications and materials.  This section gives permission for images of the Applicant named to be used as outlined below. I hereby consent and authorize the THE GYM HSV, or its assigns, to use my name and/or the names of my family members who are minors, as listed below, as well as my likeness, photos, videos and other information (or that of family members who are minors) for the purpose of news releases, advertising, publicity, publication or distribution in all forms and media. I further consent to such use in their present form and to any changes, alterations, or additions thereto. I hereby release the THE GYM HSV from all liability in connection with all such uses. *
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