Student Name(s):
__________________________________________________________________
Age(s):_________________________________
Parents Name:_________________________________
Address:__________________________________________________________________
City:_________________________________,
Zip:___________________
Telephone Number:_________________________________
Email Address:_________________________________
Emergency Contact Number:_________________________________
I give Downata Hot
Springs permission to have my child(ren) listed below, medical
treatment at their discretion in case of an emergency
situation. I certify that he/she is healthy and that there is
no medical reason why they cannot participate in this program,
nor is my child taking any medication. I further agree that I
will not hold Downata Hot Springs or employee's responsible for
negligence in the case where my child gets hurt because of
willful disobedience of the rules causing harm to himself, or
others. My child further agrees to adhere to all rules and
regulations set by swim lesson staff. We understand that should
a problem arise that an agreement cannot be reached between pool
management, swim instructor and parent, he/she will not be
allowed to continue their lesson and for said lesson will not be
refunded.
Parent's
Signature:__________________________________________
Swim Class Choices
□ Private Lesson
□
Semi-Private Lesson
□
Group Lesson (age 5 & up)
□
Parent & Child (age 5 & under)
□
Mom & Tot Learning Session
□
Lifeguard Course
□ Guard Start Program
Swim Lesson Sessions
□ June9th
- 12th
□ June
16th - 19th
□ June
23rd-26th
□ July
7th - 10th
Group Swim Class Time:
Monday thru Thursday from 10:40 am to 11:30 am
□
Semi-Private and Private Lesson time requested:_________________________________
Preferred Instructor:
_________________________________
Rates
Private: (1 child) $60 for 4 lessons and 4 all
day weekday passes.
Semi-Private: (2-3 in group) $50 for 4 lessons and 4
all day weekday passes per child.
*Passes valid Monday-Thursday (holidays excluded).
Passes must be redeemed by student only. Non transferable
Group (4-6): $40 for one week session or $60 for two week
session.
(ages 5 & up)
*One week session includes 4
fifty minute
lessons. Two week session includes 8 fifty minute sessions.
*Includes 4 weekday all day swim
passes per session. (no passes for 2nd week) Valid Monday-Thursday (holidays excluded).
Passes must be redeemed by student only. Non transferable
*Class held Monday-Thursday from 10:40 am to 11:30 am.
New sessions begins on Monday.
Parent & Child : $40
for one week session or $60 for two week session
(ages 5 & under)
*Includes 4 thirty minute
of instruction and twenty minutes of water activity.
*Includes 1 all day weekday pass
for mom & tot per session
*Underwater picture $5 extra.
One child per adult.
Mom & Tot Practice
Session: $15
We will allow mom & tots in the
pool during their other children's swim lessons. Only one
tot per mom or responsible adult. .
Moms must be with their tots in the water at all times. No
free passes included.
*Pre-payment is required to guarantee
your child's enrollment.
*If the child cannot complete a session
or does not cancel before the day of the 1st lesson, no refund will
be given or makeup days allowed.
*Some instructors will teach private and
semi-private lessons in
the afternoon or evenings upon request.Total Amount:____________ (Please call us if you need assistance)
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