Spring Swim | Alex Eligh Community

Swim Lesson Division:

Mini Reds Classes (Infants/Pre-School)

Rising reds (Ages 5 & Up)

Students First Name:

Students Last Name:

Grade:

Birth Date:

Parent/Guardian Name:

Guardian Phone Number:

Guardian Email Address

Player Medical Information We Should Know (Type "N/A" if none)

INSURANCE INFORMATION/PERMISSION TO PARTICIPATE:

The AECC does not carry any Accident Insurance for its Youth Recreation Programs. In the event that your child is injured, the family’s insurance is responsible for paying any medical bills. By signing below, you agree to these conditions and giving your child permission to participate in

Parent/Guardian Signature:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Rising Reds Swim Academy Price: $100

Swim Lesson Price (Online ONLY)

Committed to Community