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Registration
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Students Name
*
First
Last
Gender
Boy
Girl
Child's experience in the water
Student date of birth
*
***Min: 6 months AND crawling Max: 5 years or 60lbs
Primary Physician
If between grades, list the grade the Scout will be in at the start of the next school year.
Activities & Programs Registering For (Check all that apply)
Survival Swim Float Swim 4-6 weeks (required for refresher)
Refresher Course 2 weeks
Advanced Strokes – daily
Parent/Guardian Name
*
First
Last
Occupation
*
Parent/Guardian Phone
*
Parent/Guardian Email
*
Parent/Guardian Mailing Address
*
How did you hear about Aquatotz?
*
date Occupation Primary
Permission & Agreement
*
I agree and give my permission
I give permission for me/my child to participate in aquatic activity. I/My child am/is in good health and physical condition, and am/is not suffering from any condition that would prevent me/my child from engaging in this activity. Photographs and video may be taken in conjunction with lessons. I understand and agree that they may be used for informational and advertising purposes. One time administration and pool fee of $75.00 per student.
Payments are due at your first lessons. Cash, Checks, paypal, Venmo and Cashapp are all accepted.
Please read carefully and be aware that in registering your minor child for participation in this program, you will be waiving and releasing all claims for injuries you or your child might sustain as a result of participation in any class or activity conducted by Aquatotz, its agents and employees. As a parent/guardian of a participant in Aquatotz, I recognize and acknowledge that there are certain risks associated. I agree to assume full responsibility of any injuries, property damage, or loss, which I or my minor child, may sustain as a result of participating in any and all activities connected with or associated with Aquatotz. I agree to indemnify and hold Aquatotz harmless from any liability resulting from the use of premises and waive and relinquish all claims against Aquatotz facility and the owners that I or my minor child may sustain as a result of participating in any Aquatotz program. I have read and fully understand the above waiver and release of all claims, and it shall not be modified orally.
I have acknowledged the payment policy and understand there are NO REFUNDS. Checks payable to: Aquatotz.
Payment Policy and Procedures
Aquatotz Training Course (New Student)
• Every day Monday through Friday
• Approximately 4 weeks or until completed
• 10 minute individual/private lessons
• $75 Registration Fee
• $125 per week
Once the basic training program is complete the student will then move into either Maintenance or Stroke Lessons.
Refresher (Returning Student)
• Every day Monday through Friday
• Approximately 2 weeks or until completed
• 10 minute individual/private lessons
• $125 per week
Stroke and Maintenance Lessons
• 1, 2 or 3 times a week
• Maintenane lessons are 10 minute individual/private lessons. Stroke lessons are 15 minute individual/private lessons $25.00 per lesson
All lessons must be paid in full on the first day of the week for the entire week. Failure to do so will result in • your child being taken off the schedule.
Call outs: If you miss a lesson, you are still responsible for payment of the lesson. If the lesson is canceled by Aquatotz, you will not be responsible for payment of that lesson.
Sick Policy: If your child is vomiting or running a fever, please let me know ASAP and do not come to lessons. For anything else, It is ok for your child to still come if they are coughing, having a runny nose or just not feeling well. It is good for them to practice even when they aren’t 100%, because you never know when an accident can happen.
There are no credit reimbursements. All payments are non-refundable. Parent Initials_________________
Swim Diaper and Swim Suit Policy
• All swimmers under the age of 3 or not potty trained must wear a cloth, reusable swim diaper approved by Aquatotz.
For children that are not potty trained, they must wear a correctly fitted cloth, reusable swim diaper until their 3rd birthday. It may be worn under a swim suit.
If the child is not completely potty trained over the age of 3, they must wear a swim diaper. • Swim diapers must fit snuggly around the legs and waist.
• The swim diaper may not have any snaps or velcro
• Do not purchase a swim diaper with room to grow into. They must fit well to be effective. • If you do not have a swim diaper as described above, they are available for purchase for $12
eSignature of Parent or Legal Guardian
*
First
Last
*By filling out your legal name you are e-signing the agreement and permission waiver above.
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