Waiver | Swim Lessons 1

Guardian First Name

You may enter more than one name here, please put the name of the best person to contact first. (ex. Paulette and Craig; Paulette will be the first contact number if we need to reach you)

Child(ren) Last Name

This is the last name that is associated with your family details when we search for your swimmers in our system.

Have any of your children been to Carson Swim School in the past?

Primary Phone

Secondary Phone (Important, please provide)

Address

Swimmer First and Last Name (1)

Swimmer Birthday (1)

Swimmer First and Last Name (2)

Swimmer Birthday (2)

Swimmer First and Last Name (3)

If you have more than 3 swimmers, you may list all of them in this field.

Swimmer Birthday (3)

If you have more than 3 swimmers, please list their birthdays in the same order as when you entered the names.

Please indicate/explain if your child(ren) may have had any traumatic experiences around water.

Yes

If yes, please indicate child name and explain.

Please indicate/explain if your child(ren) have any health or learning concerns.

Yes

If yes, please indicate child name and explain.

Call us to schedule your classes

925-634-SWIM
(925-634-7946)

Call us to schedule your classes

925-634-SWIM (925-634-7946)

925-634-SWIM
(925-634-7946)