REGISTRATION FORM Swimmers Name: _________________________ D.O.

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

Mon/Wed (4 week lessons)

August 22-September 14
Registration deadline August 18

September 19-October 12
Registration deadline September 15

October 17-November 9

Registration deadline October 13

November 14-December 7 December 12-January 4

Registration deadline November 10 Registration deadline December 8

Tues/ Thurs (4 week lessons)

August 23-September 15
Registration deadline August 18

LEARN CONFIDENCE LEARN TO SWIM

Fall/Winter 2011 Swim Lessons

Class/Level: _______________________________
(Example: Polliwog)

September 20-October 13
Registration deadline September 15

Time: ________________________
(Example: 6:30-7:15pm)
I HEREBY, FOR MYSELF, MY HEIRS, EXECUTORS, AND ADMINISTRATORS WAIVE ANDS RELEASE ANY AND ALL CLAIMS OF DAMAGES I MAY HAVE AGINST 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

October 18-November 10

Registration deadline October 13

November 15-December 8 December 13-January 5

REUTER FAMILY YMCA

Registration deadline November 10 Registration deadline December 8

Saturday (4 week Lessons)

September 3-24 October 8-29
Registration deadline September 30 Registration deadline August 31

SIGNATURE: ________________________________________ Todays Date: ____________

November 5-26
Registration deadline October 31 We will not be holding December, Saturday lessons due to the Holidays.
3 Town Square Blvd. Asheville, NC 28803 P. 828-651-9622 F. 828-209-9615 ymcawnc.org

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 other.

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 MINNOW: This class helps to refine all strokes and an introduction to diving skills. FISH: This class works on endurance through lap swimming and drills.

Preschool

3-5 years old

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 advanced lap swimmers and we mainly focus on perfecting their strokes and diving skills.

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 Preschool $40 $70 Youth $50 $80 Adult $50 $80 (There will be a $10.00 late registration
fee if registering after the deadline.)

Adult

13-all ages

This course is designed for all levels of swimming. We range from never swam to improving lap swimming skills. Classes are diverse in age and ability and are structured to meet the needs of each individual.

Mon/Wed -7:00-7:45pm 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.

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 $20 $35 Preschool $20 $35 Youth $25 $40
(There will be a $10.00 late registration fee if registering after the deadline.)