Registration Form for the Harrisville Swim Lessons – 2018
Forms may be mailed to: Kyle Anderson, Jaquith Road Harrisville, NH 03450 or scanned and emailed to kylebud12@me.com
* Note: Please fill out one form per swimmer.
Name:________________________________ D.O.B.__________
Address:__________________________________________________________________________________________________________________________________________________________
Phone Number(s):______________________________________
Email:________________________________________________
(used often – for important information like cancellations due to weather)
Please check the swim time that you plan to attend during the summer session. Refer to the level requirements. The parent or guardian must watch their child while the child is participating in the lesson(s).
_______9:00 am – 9:30 am – Teen and Adult Swim Tips
_______9:30 am – 10:00 am –Pre-Level One
(parents must go in the water with their children)
_______11:00 am – 11:30 am – Level One
_______11:30 am – 12:00 pm – Level Two
_______12:00 pm – 12:30 pm – Level Three
_______12:30 pm – 1:00 pm – Level Four, Five, and Six
Information that you feel will be helpful and important for the instructor to know about your child while they are taking swimming lessons. Any medical needs, special services need, etc. please contact the instructor prior to lessons.
__________________________________________________________________
This is not a school sponsored event.