REGISTRATION FORM Swimmers Name: _________________________ D.O.

B:____________________ Age: _________Male______Female____ Address: __________________________________ City: __________________________ State: __________ Zip: _________________ Phone: _________________________________ Email:_____________________________________ Emergency Contact: ______________________ Emergency #:______________________________ Medical Conditions/ Special Needs: _______________________________________________ School:_____________________________________ Session: __________________________
(Example: Aug 6- Aug 16)

Mon/Wed (4 week lessons)

August 27-September 19
Registration deadline August 22 (No class on Labor Day, make-up will be September 7)

October 1-24

Registration deadline September 27

November 5-28 December 3-26

Registration deadline November 1 Registration deadline November 29

FUN. WITH A SPLASH OF CONFIDENCE.

Fall/Winter 2012 Swim Lessons

Tues/ Thurs (4 week lessons)

August 28-September 20 October 2-25
Registration deadline August 22 Registration deadline September 27

November 6-29

Class/Level: _______________________________
(Example: Polliwog)

Time: ________________________
(Example: 6:30-7:15pm)

Registration deadline November 1 (No class on Thanksgiving, make-up will be on November 23)

REUTER FAMILY YMCA

December 4-27

I HEREBY, FOR MYSELF, MY HEIRS, EXECUTORS, AND ADMINISTRATORS WAIVE AND RELEASE ANY AND ALL CLAIMS OF DAMAGES I MAY HAVE AGAINST THE YMCA OF WNC AND THEIR RESPECTIVE AGENTS, REPRESENTATIVES, SUCESSOR AND ASSIGNS FOR ANY AND ALL INJURIES WHICH MAY BE SUFFURED BY ME OR MY FAMILY IN CONNECTION WITH PARTICIPATION WITH THE YMCA ACTIVITIES AND PROGRAMS. I ALSO GRANT FULL PERMISSION TO THE YMCA TO USE PHOTOGRAPHS OR VIDEO RECORDINGS TAKEN OF ME OR MY FAMILY. I AGREE TO COMPLY WITH THE YMCA POLICY OR PROCEDURES AND UNDERSTAND THAT MY PARTICIPATION CAN BE TERMINITED WITHOUT REFUND FOR EXHIBITING INNAPROPIRATE BEHAVIOR OR ABUSE TOWARDS THE YMCA STAFF AND/OR FACILITES

Registration deadline November 29 (No class on Christmas make-up will be December 28)

Saturday (4 week Lessons)

September 1-22 October 6-27
Registration deadline August 28 Registration deadline September 25

SIGNATURE: ________________________________________ Todays Date: ____________

November 3-24 December 1-22

Registration deadline October 30 Registration deadline November 27

My child gained confidence and a love for the

3 Town Square Blvd. Asheville, NC 28803 P. 828-651-9622 F. 828-209-9615 ymcawnc.org

water because of his swim lessons at the YMCA. -Joey O.

Parent/Child

6-36 months

Youth

6-12 years old

Private Lessons
Private Lessons are packaged in sets of 4 half hour lessons Private $80 Semi-Priv. $116 $100 $146

SKIP: Also known as Parent/Child is a class we offer to help babies and young children get used to the water. It is a great class for children and parents to learn and play while interacting with one another.

Tues/Thurs- 9:30-10:00am Saturdays- 9:00-9:30 am

Polliwog: This class is for beginner, school age children to become acquainted with the water and learn basic stroke skills. GUPPY: This class focuses on free style, back stroke, side stroke, breaststroke, and elementary backstroke development. MINNOW: This class helps to refine all strokes and gives an introduction to diving skills. FISH: This class works on endurance through lap swimming and drills.

Preschool

3-5 years old

Mon/Wed -7:00-7:45pm Tues/Thurs -4:30-5:15pm Saturdays-10:15-11:00am

Swimming Lesson Costs

WEEKDAYS Mon/Wed or Tues/Thurs (4 WEEKS 8 LESSONS) Member Non Parent/Child $45 $75 Preschool $45 $75 Youth $55 $85 (There will be a $10.00 late registration
fee if registering after the deadline.)

PIKE: This class is for beginners. We work on basic strokes and becoming comfortable in the water. EEL: This class is for kids that are comfortable in the water. We learn how to swim without assistance and how to swim under water. RAY: This class is for children who know how to swim without help across the pool. We work on all major strokes and some diving skills STARFISH: This class is for strong swimmers and we mainly focus on perfecting their strokes and diving skills.

There must be a minimum of 3 participants signed up to hold each class. We cannot shift students into other classes if you cannot attend the class you are scheduled for. Classes will only be made up due to the YMCA cancelling a class.

Mon/Wed -6:30-7:00pm Tues/Thurs- 9:00-9:30am Tues/Thurs -4:00-4:30pm Saturdays-9:45-10:15am

SATURDAY LESSONS (4 WEEKS 4 LESSONS) Member Non Parent/Child $25 $40 Preschool $25 $40 Youth $30 $45
(There will be a $10.00 late registration fee if registering after the deadline.)