Delaware Registration

Right Class - Right Stroke - Right Start

Open to all swimmers: One-to-one lessons for individuals aged (3) to adult that require more personal attention or have limited time available for instruction. Creating an environment that enables swimmers to develop at their own pace, learn safety in and around the water and encourage life-long swimming skills. We will come to your home, community, condo, or vacation pool and offer private “Learn to Swim” or “Stroke Mechanic” instruction.

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CONTACT INFORMATION:

Name *

Location *

Cell Phone *

Email *

What type of pool are you using?

Address or Location of Pool *

Address Line 1

City

State

Zip Code

Emergency Contact *

Cell Phone *

PRIVATE SWIMMER REGISTRATION:

Name *

D.O.B *

Age *

Gender *

PREFERRED TIME SLOT:

START DATE: *

PREFERRED DAY *

PREFERRED DAY

(2nd choice – optional)

PREFERRED TIME *

MONTHS AVAILABLE? Check all that apply *

June
July
August
September

Participation in Ocean City Aquatics is intended to promote healthy and safe swimming opportunities for myself, child and or children. Like many physical activities, swimming and associated activities pose certain inherent health risks that can result in serious injury (physical and/or emotional) or even death. I acknowledge and assume the risk inherent with myself, child/children active participation in Ocean City Aquatics. Failure to follow safety instruction may lead to my child/children suspension or cancellation of swim instruction. Discretion is left entirely to the Ocean City Aquatics staff to determine whether and when removal is appropriate. I give consent and permission for the taking of photography and/or video and/or audio of participants to be utilized for instruction and/or advertisement.

Release and wavier: By signing this form, I acknowledge that I have been informed about certain risk and responsibilities in this program. I am acknowledging that I am knowingly and voluntarily assuming the risk. Further, by signing this form, I also agree, for myself, my heirs and assigns to release and hold harmless Ocean City Aquatics its employees and agents, from any legal claim or liability for any bodily injury and personal property damage that is caused to me by the negligent act or omission of persons not a party to this agreement. I further understand that my child/children cannot be left unattended during swim instruction. This waiver applies to all current and future swim classes and/or lessons taught by Ocean City Aquatics.

Payment Method *

Verification *

I have read and agree to the Participation, Release and Wavier.

Security Verification *

Type the word SWIM in the box below

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