SQUIDS 2023 WAITING LIST

Parents/Guardians Details

Parent/Guardian 1 *

First

Last

Parent/Guardian 2

First

Last

Street Address

Address Line 1

City

State / Province / Region

Postal Code

phone numbers

Parent/Guardian 1 Phone Number *

Parent/Guardian 2 Phone Number

Email *

Confirm Email

Participant Details

Layout

Child's Name *

First

Last

Child's Age *

Does your child have a health care need that could affect their safety in or near the water? *

Are you a pool member? *

Yes - $ 70.00
No - $ 105.00

Please purchase a pool membership before enrolling your child to avoid the extra cost. Membership status will be checked and position may be forfeited if false information is received after payment has been submitted.

I agree with the following terms

My child is 5 years or over
I have been truthful with my child's Pool Membership status.
I give consent for my child to participate in swimming/aquatic lessons in the Jamestown Pool
I understand that the instructor may need to help my child physically to ensure my child's safety and learning of the swimming techniques.

Please sign to acknowledge you have read the above *

If successfully accepted this will be the cost

$ 0.00