<p> City of Memphis Division of Park Services, Aquatics & Make a Splash Mid-South Pilot Swim Lesson Program</p><p>Free Swim Lesson Verification Form</p><p>Name of Swimmer:______</p><p>Name of Parent/Guardian Registering Child:______(Parent or Guardian only must register child)</p><p>Date: ______</p><p>Document verification: Please place a check next to the documents received and verified, as well as answer the following questions:</p><p>______Birth Certificate for the child</p><p>______Driver’s License or Photo ID for the Parent or Legal Guardian</p><p>Yes or No Does the Parent’s name on the birth certificate or Legal Guardian documentation match the photo ID (please circle)</p><p>Free Swim Lesson Verification (Please check the type of document that was presented and attach to the application)</p><p>______AFDC Award Letter</p><p>______Food Stamp Award Letter (child’s name must be listed)</p><p>______Social Security for the Child (child’s name must be listed)</p><p>______Disability for the child (child’s name must be listed)</p>