2015 Swimming Lesson Registration Form

2015 CANORA SWIMMING POOL
LESSON REGISTRATION FORM
Name: ________________________________________________________________ Age: _______________
1)
Parents Names: _____________________________________________ Phone #: 2) ______________________
Address: ___________________________________________________Town: _________________________
Postal Code: _____________________SK Hospitalization Card #:____________________________________
In emergency, contact: ________________________________________Phone #:________________________
Tell us of any special medical conditions you may have: ____________________________________________
Please check mark () your choice of session dates.
If you are enrolling in more than one session, please use separate forms.
ALL lessons & passes must be paid in FULL at time of registration.
NO registrations will be accepted without payment & NO post-dated cheques will be accepted!!
Sorry for the inconvenience!
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 Session 1 – June 15 to June 26th, 2015
Registration Deadline: June 1st, 2015
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Session 2 – July 20th to July 31st, 2015
Registration Deadline: June 30th, 2015
Session 3 – August 3rd to August 14th, 2015
Registration Deadline: July 25th, 2015
Private Lessons – DATES & TIMES TO BE DETERMINED BY MANAGER AT A LATER DATE
Date of preference: 1)_______________________
2)__________________________
 Monitored Lane Swim – to run twice/week (July & August)
*Swimmers must have completed all levels of the Swim Kids program to take part.
Please indicate which level of Red Cross Swim lessons you are enrolling in by  the level name/number:
Swim Preschool
*This program is designed for swimmers 4 months to 5 years of age.*
 Starfish (Parental Supervision Required)
 Salamander
 Duck (Parental Supervision Required)
 Sunfish (Level 1)
 Sea Turtle (Parental Supervision Required)
 Crocodile (Level 2)
 Sea Otter
 Whale (Level 3)
Swim Kids
Please circle the lesson you are enrolling in:
*This program is for swimmers 6 years of age & older.*
1
2
3
4
5
6
7
8
9
10
Red Cross Assistant Lifeguard & Lifeguard courses may be offered in July and August, depending on
interest. If you are interested in any of these courses, please contact the pool any time after May 4th, 2015.
*PRICES & DATES of season passes, swimming lessons, private lessons and monitored lane swims are subject to change at any time*
Parent/Guardian Signature: ___________________________________Date:_____________________________
OFFICE USE ONLY
Season Pass Amount:
$____________
Lesson Amount:
$____________
Total:
$____________
Receipt Amount:
$____________
Receipt Number:
#_______________________
Paid by:
Cash
Receipt Issued:
Cheque
Yes
Credit Card
No
Monitored Lane Swim:
With a pass $42.00 (+pass amount)
Without a pass $48.00
Swimming Lesson Fees:
With a Pass
Preschool
- $24.00 (+ pass amount)
Levels 1-3
- $24.00 (+ pass amount)
Levels 4-7
- $27.00 (+ pass amount)
Levels 8-10
- $35.00 (+ pass amount)
Season Pass Fees:
Pre-school (Age 3-6)
$ 25.00
Child (Age 7-14)
$ 50.00
Student (Age 15-17)
$ 64.00
Adult (Age 18+)
$ 76.00
Family
$151.00
Senior (55+)
$ 69.00
Without a Pass
Preschool - $47.00
Levels 1-3 - $47.00
Levels 4-7 - $53.00
Levels 8-10 - $64.00
Private Lessons:
Preschool- Level 3 $100.00 / 2.5 hrs
Level 4-6  $110.00 / 3 hrs & 45 mins
Level 7-10 $122.00 / 5 hrs