Priva
P
te Sw
wim Less
sons
Improve or masteer your swimming skills with
w individua
alized attentiion from
“Ameerica’s Favorite Swim Insttructors.” Insstructors, participants annd/or parentss
workk together to
o determine goals
g
for the session and lessons are then custom
mized
in orrder to meet the establish
hed goals. Prrivate lessons are great ffor beginnerss,
peop
ple with disab
bilities, people who have had a negative experiencce with wateer
or fo
or those who want to imp
prove their skkills in a private setting.
Classses are 45 minutes
m
long at
a the Y pool.
Pleasse turn in your registratio
on form, payy and we'll call you
to scchedule a con
nvenient timee.
COST
T:
Member:
M
$40 per
p lesson, $1
160 for 4, $320 for 8
Non-member: $45 per lesso
on, $180 for 4, $360 for 8
YMCA Pool, 11
155 N. Court Street,
S
Redding CA
LOCA
ATION:
REGISTRATION: Open Now
CLASS NAME:
PLEASE MARK THE
E NUMBER OF LESSONS YOU
U WOULD LIKE
E:
1 LESSON
N:
PART
TICIPANT’S NA
AME:
D.O.B.:
ADDR
RESS:
CITY, STA
ATE, ZIP:
PARE
ENT’S NAME:
PARENT D.O.B.:
HOME PHONE #:
OTHER P
PHONE #:
EMAIL:
☐ MALEE
4 LESSONS:
8 LESSONS:
☐ FEMALLE
Shasta Family YMCA Prog
gram Waiver
I hereb
by agree for myselff, my child(ren), myy heirs, executors and
a administratorss, to indemnify, deefend and hold the Shasta Family YM
MCA and its officers, directors, board
membeers, employees, vollunteers, agents, in
ndependent contra
actors and other participants in the pprogram, harmlesss from any and all liability and claimss with respect to
any bodily injury, personal injury or illness,, including death, or
o property damage which may occurr to myself or my cchild(ren) or which may be aggravateed by participating
in a YM
MCA program. I take full responsibiliity for my welfare and safety, and th
hat of my minor ch ildren, during Shassta Family YMCA aactivities and know
w that activities
should only be engaged in by those in good
d health and that I should consult a physician before eenrolling in a YMCA
A program. I underrstand the Shasta FFamily YMCA
carriess no medical insura
ance, and it is expe
ected that I have health
h
insurance to
o cover any injuriess or losses. In casee of accident or illn
ness, the Shasta Family YMCA has
my perrmission to secure the necessary med
dical attention if unable
u
to contact me
m or if I am unablle to give consciouus permission. I, individually, and on behalf of any
minor cchildren, hereby re
elease the Shasta Family
F
YMCA from any claim whatsoeever which may ariise as a result of aany first aid treatm
ment or assistance provided to me in
connecction with any injurry that arises from
m participating in a YMCA activity. I consent to be phootographed and to
o allow the Shasta Family YMCA to u
use photos taken of
me and
d/or my minor child
dren for promotion
nal purposes.
PAREN
NT SIGNATURE::
FOR O
OFFICE USE: Da
ate:
Date:
Amt. Paid:
Staff In
nitial:
Shasta
a Family YMCA
A • 1155 N. Court
C
St., Redding, CA 960
001 • (530) 24
46-9622 • w
www.sfymca.o
org