Swimming Registration for Arbor Swim Club

Participant’s name:______Age:______Parent/ Guardian’s name:______Address:______City:______Zip______Day phone: ______Evening or cell phone: ______Who should we call in case of accident? (1) ______(2) ______(3) ______Doctor’s name:______Doctor’s number:______Dentist’s name:______Dentist’s #______Session ______Date ______

I verify that all of the above information is true and correct, I understand that until the full payment for the session has been paid (check has cleared bank) that my child is not registered and I understand that by registering for this swimming activity that I am releasing Jeanne and Dave Murray from any liability due to injury or death resulting from participation in this aquatic program, including theft of my belongings during the swimming lesson. Please sign:______

*All guests & children must stay off the pool deck. Only swimming participants may be on the pool deck, and spectators must wait on the shaded patio below the pool without interfering with the lesson. Please sign:______

Refunds will not be given for days you miss our scheduled lessons because we are holding a place for you. Any lessons missed due to rain or bad weather/instructor illness/or pool malfunction will be made up on the next Friday at the same time. Refunds for lessons missed, minus a $25.00 registration fee, will be given if you need to drop out of the lessons for any reason. Please sign:______

Please park in front of my home or pull up in our driveway. Please do not park in front of our neighbor’s homes. *Drive slowly on our street because there are little children outside at play. Please arrive dressed in your bathing suit, ready to go, as no changing/restroom facilities are available. Please DO NOT BRING SMALL CHILDREN AS SPECATORS (unless you are able to keep them under control and seated right by you).

Please sign: ______

Payment in FULL needs to be made by the time of the 1st lesson.

Please make checks for the full amount payable to Jeanne Murray. Write your child’s name and include this waiver in an envelope and mail to: 6225 Harrogate Drive – Austin, TX 78759. I will call you to confirm when I have received your letter.

Signature of Parent/Legal Guardian or Participant ______/ Date:______

Arbor Swim Club reserves the right to refuse service based on disciplinary, medical, or hygienic reasons.

Arbor Swim Club ONLY takes students that are potty trained. Any bodily accident (that includes bodily fluids, throwing up or pooping in our pool will incur an additional charge of $60.00 to cover the lost time & expense to return the pool to its Original Condition.