2022 Summer Break Waiver for Guest Rules, Rock Wall & COVID
Required form for everyone coming to Summer Break Swim Club as a guest
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List family member #1 to be included on the waiver (This MUST be the LEGAL GUARDIAN if children are being added to the form) *
List family member #2 to be included on the waiver
List family member #3 to be included on the waiver
List family member #4 to be included on the waiver
List family member #5 to be included on the waiver
List family member #6 to be included on the waiver
I am the legal guardian to ALL minor(s) listed on this waiver. *
Required
Emergency contact Name *
Emergency contact phone number *
What is the emergency contact's relationship to the minors? *
I have visited www.summerbreakfishers.com and read the Pool Rules and the waivers for the Rock Wall and COVID-19 Waiver *
Required
By typing my name below, it will act as an electronic signature verifying that I am the parent or guardian to the listed minors on this form and I have read the online pool rules, rock wall waiver and COVID waiver and agree to the legal terms and conditions outlined for all people on this form for the entire 2022 season. *
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