2024 JUNE EagleVail Swim School Registration Form
Step 1 of 2: Submit
*** CHILD MUST BE REGISTERED BY MAY 31 ***
Please complete
ONE FORM
per child.
June 2024 Lessons: Session 1
MONDAYS and WEDNESDAYS (Nemos ages 4-5), June 10 - July 3, eight half-hour lessons
Class Type
Nemos, 10am, ages 4-5: $160
Nemos, 10:45, ages 4-5: $160
TUESDAYS and THURSDAYS - FULL
FULL
Saturday Classes for June
ALL SATURDAY CLASSES ARE FULL.
ALL SATURDAY CLASSES ARE FULL.
Parents' Names
*
Emergency Contact Information
*
Swimmer's Name
*
Age
*
Physical Street Address
*
Physical City, State, Zip
*
Billing Street Address (if different from physical address)
Billing City, State, Zip
Cell 1
*
Cell 2
Email
*
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.).
Parental Signature
Medical and 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, Swim School, 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.
Parental Signature
*
Credit Card Information:
Credit Card Type
*
Select an option:
Visa
Mastercard
American Express
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
*
*
indicates required fields