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Red Cross Swim Lesson Registration Form

Student Name(s):
__________________________________________________________________
Age(s):_________________________________
Parents Name:_________________________________
Address:__________________________________________________________________
City:_________________________________,  Zip:___________________
Telephone Number:_________________________________
Email Address:_________________________________
Emergency Contact Number:_________________________________
 
Release Form must be signed before class begins.  Click on link to download form:   RELEASE FORM

Swim Class Choices

Private Lesson
Semi-Private Lesson (2 students-any age-same level)  -
Group Lesson (3-6 students-any age-same level)
Pre-School Aquatics:  (age 4 & 5) (4 in group)
Parent & Child (age 6 months to 3 years)
Mom & Tot Learning Session
Swim Club
 
2013 Summer Swim Lesson Sessions  Sessions available Monday-Thursday
Sessions Dates:   6/10 to 6/13, 6/17 to 6/20, 6/24 to 6/27, 7/8 to 7/11, 7/15 to 7/18, 7/22 to 7/25

Parent/Child (6 mos-3 years)   Requested time & date:__________________
     *
25 minute lesson    9:30 am 10:30 am sessions.
 

Preschool (age 4 & 5):  Requested time & date________________________
     *25 minute lesson    9:30 am 10:30 sessions.

 
  Group:   Requested time & date._______________________________
    *45 minute lesson   9:30 am or 10:30 am sessions available

Semi Private:   Requested time & date._______________________________
    *45 minute lesson   8:30  am sessions available
 
Private:  Requested time & date.____________________________________
    *45 minute lesson   8:30 am sessions available
 
 
Preferred Instructor: _________________________________
 
*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. 

Total Amount:____________ (Please call us if you need assistance)

 Print and mail this form and send a check payable to Downata Hot Springs or call with a credit card payment.
Downata Hot Springs, P.O. Box 185,  Downata Road, Downey, Idaho 83234  ●
(208) 897-5736

Downata Hot Springs ▪ P.O. Box 185, 25900 S. Downata Road ▪ Downey, Idaho 83234  ▪
(208) 897-5736

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