2024 Junior Lifeguard Camp Registration Form

***** ALL CHILDREN MUST BE AT LEAST 10 YEARS OLD AND BE ABLE TO SWIM 300 METERS FREESTYLE CONTINUOUSLY TO PARTICIPATE *****

August 7-8, $180/child, includes t-shirt and Red Cross CPR Certification.

Please complete ONE FORM per child.

Child's Name Child's Age

Parental Information:

Parents' Names Physical Street Address Physical City, State, Zip Billing Street Address (if different from physical address) Billing City, State, Zip Cell 1 Cell 2 Email 1 Email 2

Photography Release:

I agree to allow the EagleVail Pool to use any photographs of my child taken at the EagleVail Pool or events for promotional purposes (e.g. brochures, website, advertisements, etc.).

Signature

Medical & Liability Waiver:

A representative of the EagleVail Pool has my permission to seek emergency medical aid for my child, named above, if necessary. The EagleVail Pool does not provide medical coverage for individual participants. All medical insurance must be provided by parents. I will not hold the EagleVail Pool or the coaching staff liable in case of accident or injury sustained as a result of participation in this program. I understand the risks involved with this activity and know that my child is physically able to participate. I hereby give my consent and approval for my child to participate in this activity. All fees are non-refundable. By signing below, I attest that I have read and understand this release form in its entirety, and agree to all the terms and conditions set forth within.

Signature

Credit Card Information:

Credit Card Type Credit Card Number Expiration Date CVV Code

By checking the 'I Agree' box and entering your name in the Signature Box, you are authorizing EagleVail Swimming Pool to charge your credit card and you understand that there is no guarantee of entry if the pool is at maximum capacity.

'I agree' to the terms and charges. Electronic Signature