Free Swim Lesson Registration Form Template

Swim Lesson Registration Form

Please complete this form to register for swim lessons.

Personal Information

Name

    Age

      Address

        Phone Number

          Email

            Emergency Contact Information

            Name

              Relationship

                Phone Number

                  Lesson Information

                  Preferred Lesson Type

                  • Private

                  • Group

                  Skill Level

                    Preferred Day(s)

                      • Monday

                      • Tuesday

                      • Wednesday

                      • Thursday

                      • Friday

                      • Saturday

                      • Sunday

                      Preferred Time Slot

                        • Morning

                        • Afternoon

                        • Evening

                        Medical Information

                        Known Medical Conditions

                          Allergies

                            Payment Information

                            Payment Method

                              • Credit Card

                              • Debit Card

                              • PayPal

                              • Check

                              • Cash

                              Payment Proof

                                Consent

                                I, the undersigned, hereby agree to participate in swim lessons provided by [Your Company Name]. I acknowledge that participation in swim activities involves certain risks, and I voluntarily assume all risks associated with such activities.

                                I release [Your Company Name], its instructors, and affiliates from any and all liability for injuries, loss, or damage that may arise from my participation in these lessons, except in cases of gross negligence.

                                • I confirm that I have read, understood, and agree to all terms of participation.

                                Name:

                                Date:

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