Aqua Programs at Little Fins

PLEASE FILL OUT THE REGISTRATION FORM BELOW PRIOR TO ATTENDING ANY PROGRAM.

 

Aqua Programs Registration Form 

Please complete the form below

Participant Name *
Participant Name
Phone *
Phone
Address *
Address
How did you hear about Aqua Programs at Little Fins? *
Which Little Fins Program(s) are you interested in? *
Please select all that apply to you/your family.
Please note anything special you would like us to be aware of, including any special concerns.
Waiver/Release of Liability *
This is a release of liability and waiver of certain legal rights. I, the listed participant(s) above, agree and understand that swimming is a hazardous activity. I recognize that there are risks inherent in the sport of swimming, including but not limited to paralyzing injuries and death. I hereby agree to allow the participant(s) listed above to participate in swimming activities, programs, and classes at Little Fins Swim School. I hereby agree to indemnify and hold harmless Little Fins Swim School, its affiliates, and its teachers and staff from any liability or form of damages that may occur to the participant(s). I hereby agree to indemnify Little Fins Swim School, its affilitates, and its teachers and staff from any damages incurred arising from claims, demand, action or cause of action by participant(s).
Medical Consent *
I hereby authorize any representative of Little Fins Swim School to allow the participants to be treated in a medical emergency during participation at Little Fins Swim School activities or swimming lessons. I further agree to pay all cost associated with medical care and/or transportation for the participant(s).
Photo Release *
I understand that photos/videos may be taken at Little Fins. I grant permission to Little Fins and affiliates to take photographs and videos, which may be used for advertising purposes. I agree that such photographs/videos may be used with or without my name for any lawful purpose, including for example, publicity, illustration, advertising, social media and web content.
Prenatal Swim Class Medical Release of Liability
I have voluntarily enrolled in a fitness program offered through Little Fins Swim School. I recognize that the program may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I have been advised that an examination by a physician should be obtained by anyone prior to commencing a fitness and/or exercise program, or initiating a substantial change in the amount of regular physical activity performed. If I have chosen not to obtain a physician’s consent prior to beginning this fitness program, I hereby agree that I am doing so solely at my own risk. I understand that it is my sole responsibility to participate in exercises that are appropriate for the current status of my health. If I have any questions or concerns about whether or not a particular activity is appropriate to my current health status, I understand it is my responsibility to ask my doctor if this activity is appropriate before I participate in such activity. I waive and release Little Fins Swim School and Heather Thomas, RN, and its successors and assigns, from any and all claims, costs, liability and expense for any injury, loss or damage whether known, anticipated or unanticipated arising from my voluntary participation and enrolment.
I HAVE CAREFULLY READ THE ABOVE INFORMATION AND SIGNED IT WITH THE FULL KNOWLEDGE OF ITS CONTENTS AND SIGNIFICANCE. Please type your electronic signature.
Date *
Date