Course Pre-Requisites

All candidates must be 15 by the last day of the course offering. Prior to being allowed to take the American Red Cross Lifeguard course, candidates must be able to:

How The Class Works

Students must attend all classes in order to pass the course. The first day of class students will be introduced to the course, given materials, and be asked to preform the pre-requisite skills. The second day of class students will become certified in CPR and AED for Lifeguards. The third day consists of First Aid training, basic water rescue skills, and in water simulations. The last day of the course students will learn spinal injury procedures, preform final scenarios, and take the final exam.

Initial Each Below

REFUND POLICY/PAYMENTS Initial Each ______ Payments: Registration is on a first come, first serve basis. YMCA reserves right to cancel class with insufficient registration. Payment in full is required at registration. _______ Cancellation Policy: Some programs require a minimum number of participants to hold class. If minimum numbers are not met 3 days prior to first day of class, participants will be notified that class may be postponed or cancelled. If YMCA cancels, refund or on-line credit will be issued. _______ Refund Policy: Y Cancels Program 100% refund refund check will be issued within 10 business days. Participant Cancels Participant cancels prior to first class 100% refund (Less $5.00 Administration Fee) Participant cancels after first class 50% refund - (Less $5.00 Administration Fee) Participant cancels after second class 25% refund - (Less $5.00 Administration Fee) Participant cancels after third class No refund

Swim 300 yards continuously using both the freestyle and breast strokes. Swim 25 yards, surface dive to a depth of at least 8 feet, retrieve a 10 pound object from the floor of the pool, and return it to the start position by swimming on their back with the object in both of their hands. This must be accomplished in under 1 minute 40 seconds. Tread water for two minutes with their hands placed inside of their armpits.

What To Bring
Everyday it is important to bring:

Students will be allowed two attempts at these skills. If they can not pass after the second attempt they will not be allowed to continue in the class. It is recommended that you schedule a time to come in to practice these skills prior to the first day of class.

Bathing Suit (preferably a one-piece) Towel Warm Clothes for after water sessions Lifeguard Manual CPR Mask Pencil and Highlighter Snacks

For More Information Contact: Karen Budro Healthy Living Director Aquatics 828 692 5774 kbudro@ymcawnc.org

REGISTRATION FORM Name: ____________________________________________ D.O.B:____________________ Address: __________________________________ City: __________________________ State: __________ Zip: _________________ Phone: _________________________________ Emergency Contact: ______________________ Emergency #:______________________________ Medical Conditions/ Special Needs: _______________________________________________
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 SUFFERED 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 INNAPROPRIATE BEHAVIOR OR ABUSE TOWARDS THE YMCA STAFF AND/OR FACILITES.

Dates
Sept. 26, 2012 to Sept. 29, 2012 Dec. 26, 2012 to Dec. 29, 2012 Feb. 27, 2012 to March 2, 2013 April 24, 2013 to April 27, 2013 June 26, 2013 to June 29, 2013

Save A Life: Become A Lifeguard

Times
Wednesday, Thursday, and Friday 4pm - 9:15pm Saturday 9am - 4pm

Costs
Lifeguard Class:
Member: $185.00 Non Member: $200.00

Recertification:
Member: $125.00 Non Member: $140.00

SIGNATURE: ________________________________________

CPR Certification Only:

Member $40.00 Non Member: $65.00 Hendersonville Family YMCA YMCA of Western North Carolina 810 6th Avenue West Hendersonville, NC 28739 828 692 5774

Todays Date: ____________