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Winter 2019 - Swimming Lesson Registration Form

  1. Month / Day / Year

  2. Red Cross Swiming level you want to register in:

    (Select only one)

  3. Parented (3-36 months) *

  4. Preschool (3-6 years)*

  5. Swim Kids (5 +)*

  6. Does your child have any other siblings that you are registering?

    (If so please write their names and select their levels in the space below. This will help us place your children in the same lesson set if possible)

  7. (Be sure to fill out a separate form for each sibling)

  8. (Be sure to fill out a separate form for each sibling)

  9. (Be sure to fill out a separate form for each sibling)

  10. Important dates and information:

    Please read the following carefully:

  11. • Lesson Applications must be sent in or returned to the Northern Lights Aquatic Centre on or before December 17, 2018.

  12. • You will receive a phone call confirming your lessons dates and times on or before December 28, 2018.

  13. • After receiving your confirmation call, payment must be received no later than January 4, 2019. If payment is not received on or before the due date, you will be removed from the class list

  14. • Please note this does not guarantee your child a spot in lessons, though we will do our best to accommodate as many people as possible

  15. Electronic Signature

  16. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that your application will not be signed in the sense of a traditional paper document. By signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature.

  17. Leave This Blank:

  18. This field is not part of the form submission.