Lesson Registration - Patrick Zierke

Course Date of Completion *

This is shown on your certificate. Certificates are valid for one year from date of completion.

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Contact *

First Name

Last Name

Phone *

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Swimmer 1 Name *

First Name

Last Name

Swimmer 1 Date of Birth *

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Swimmer 2 Name

First Name

Last Name

Swimmer 2 Date of Birth

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Swimmer 3 Name

First Name

Last Name

Swimmer 3 Date of Birth

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It's Your Choice *

Swimming pool businesses, water parks, hotels, and water front facilities do their best to provide a safe environment for your activities. You are responsible for making good choices. You are responsible for selecting the programs and activities suited to your skills, abilities, and health. By electing to use the facilities and participate, you assume all risk for any harm or injury you sustain. By your voluntary participation as a participant or spectator, you could be injured. Take responsibility. Do not take risks or do activities that may not be appropriate. Ask questions. If you have any questions about your health and how it might be affected by exercise, by being in the water, or by other activities at a facility, contact your doctor and obtain permission before participating. A complete physical is recommended before beginning any exercise program. Pay attention to your surroundings. Be aware of the presence of others while you participate. Do not engage in activities that could injure others. Report any unusual significant hazard during your presence or participation and remove yourself from participation. If you bring belongings, you are responsible for their care and safety. They could be lost, stolen, or damaged. Contact a staff member if you have any problems or concerns. For every activity in and near water, finish with the same number of children that you started with. It's your responsibility. It's your choice. Coach Shelby and I rarely cancel events due to weather conditions. We often arrive at a pool long before the weather turns bad. We're already here, so we keep teaching. We try to stick to our schedule whenever possible. Weather conditions can change quickly and can vary dramatically from neighborhood to neighborhood. Whether or not to venture out on severe weather days is also your choice. Make good choices for your family.

It's my choice. It's my responsibility.

Swim School Uniform *

All swimmers ages 3-14 are required to wear a solid-color, one-piece, competition style training suit to all lessons. I will provide caps and goggles for all the Instructional and Developmental swimmers. Voyagers are required to bring their own caps and goggles to every practice.

My swimmer(s) will wear the required uniform/equipment.

No Make-Ups / Lesson Swap & Share *

Attendance at all lessons is not required, but please try to make as many as you can. I do not provide make-up lessons for lessons missed due to weather-related cancellations, illness, or conflicts with other activities. Coach Shelby, Coach Terri, and I, all participate in lessons swaps. You may swap your lesson time with anyone else in our programs. You may also send a friend, neighbor, relative to use your lessons if you have to miss. Use the FUF Lesson Swap facebook page to advertise and find swaps.

There are no make-up lessons. I may swap/share my lessons.

Photography Policy *

Images of your child participating in lessons may be used (without names or other identifying information) in my brochures, website, and social media.

I agree to the photography policy.