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DS2 - Swimming Lesson and Pool Consent Form

This document is a consent form for swimming lessons at a pool. It collects basic participant details like name, date of birth, gender, and medical conditions. It outlines the rules for pool use and swim lessons, including that a guardian must remain onsite. It releases the pool of liability and consents to emergency treatment if needed.

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82 views

DS2 - Swimming Lesson and Pool Consent Form

This document is a consent form for swimming lessons at a pool. It collects basic participant details like name, date of birth, gender, and medical conditions. It outlines the rules for pool use and swim lessons, including that a guardian must remain onsite. It releases the pool of liability and consents to emergency treatment if needed.

Uploaded by

hasoxow489
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Darshanam Splendora 2

Swimming Lesson and Pool Consent Form


Basic Participant Details
Participant’s Name ______________________ Birthdate _________________ Gender: M / F
Parent/Guardian (if under 18) __________________________________________
Parent Phone ______________________________ Flat # _____________________
Session Date: 15-Apr-2024 to 10-May-2024___ Batch #___________
Batch 1: 6:30 pm to 7:30 pm (Monday – Friday)
Batch 2: 7:30 pm to 8:30 pm (Monday – Friday)
Participant Medical Condition
Are there any medical conditions that we need to be aware of for the swim lessons? If so, what?
_________________________________________________________________________________________
_________________________________________________________________________________________
By signing below, I understand the following:

 I understand and agree to abide by all rules and health conditions required for use of the
pool.
 I understand and agree that for all lessons for minors, a parent, guardian, or other
designated adult will remain onsite to oversee the swim lesson.
 I understand that this regulation is required for the protection of both the student and
the instructor.
 I understand and agree that appropriate physical contact will be necessary to encourage
proper swim skills and techniques.
 I understand that no refunds are available once payment is made.
PARTICIPANTS/PARENT/GUARDIAN: Please read and sign.

 I understand that participation could include actions or tasks which might be hazardous
to the participant.
 By signing below, I assume any risk of harm or injury which may occur to the participant
due to their participation in the event or activity.
 I release DS2 Hobby Team, DS2 EC Team and Coach/Swimming Instructor. from all
liability, costs and damages which may arise from participation in any event or activity at
pool.
 If the participant is a minor, I agree that he/she has my consent to participate in any
event or activity.
 I further provide my consent for Coach/Swimming Instructor to seek emergency
treatment for the minor if necessary.
 I agree to accept financial responsibility for costs related to emergency treatment.

_____________________________________________ ________________ ____________


NAME OF PARTICIPANT / GUARDIAN (IF UNDER 18) SIGNATURE DATE

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