American Red Cross Water SafeAmerican Red Cross Water Safety Instructor

 

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2 Learn 2 Swim
 with
 Susan Ferrer

2 Learn 2 Swim Registration

Please fill out the registration form. Under "comments" you can add any other information you think might help us to provide your child with a better program or is important regarding health ie., allergies etc. Fees will be collected (check or cash only) on site the the day of your 1st lesson. Thank you.

Swimer's Information
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Parent Information
Full Name:
Contact Information
Daytime Phone:
Evening Phone:
Email:
Swimmer's Level and Age
Swimmer's Level
Swimmer's Age years old
Aditional Information and Waivers
How did you find me
Lesson Location
Lesson Type
Registration
Agreement
I agree to abide by all rules, regulations, and by laws as set forth by Ferrer Enterprises Inc, Susan Ferrer, their assigns, licensees and legal representatives. I represent that I am a parent/legal guardian to the participant and I agree and understand that all deposits and fees are non-refundable.

I HAVE READ THIS REGISTRATION AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
                I
have read and agree with this Registration Agreement (Initial box if agree)
Liability
Release
Waiver
In consideration of being allowed to participate in any way in Ferrer Enterprises Inc, Susan Ferrer, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next to kin, HEREBY RELEASE AND HOLD HARMLESS Ferrer Enterprises Inc, Susan Ferrer, their officers, officials, agents and / or employees, other participants sponsoring agencies, sponsors, advertisers, and, if applicable, (owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE; and,

5. I willingly agree to comply with all rules and regulations set forth; and,

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
                I have read and agree with this Liability Release Waiver  (Initial box if agree)
Model
Release
Waiver
I, do hereby give Ferrer Enterprises Inc, Susan Ferrer, their assigns, licensees and legal representatives the irrevocable right to use both the participant and my picture, name, and likeness free of charge in any manner for any purpose without compensation to participant or me in all manners, for advertising, trade, or any other lawful purposes, and I waive any right to inspect or approve the finished product, including written copy, that may be created in connection therewith. I represent that I am a parent/legal guardian to the participant and I agree that the grant and release contained therein binds me and the minor to all of the terms; and

I HAVE READ THIS MODEL RELEASE, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.



                I have read and agree with this Model Release Waiver  (Initial box if agree)
Other Information
Comments:


                                     1/2 Hour Swim Series
                                        Buy 6 Get 1 Free
                                            

                                      1 Hour Swim Series
                                        Buy 6 Get 1 Free
                                           
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