Sharx Swim lessons

STROKE INSTRUCTION PROGRAM
NORTH CHEVY CHASE SWIM TEAM
TOLLEFSON SWIMMING

Summer 2007

Tollefson Swimming is providing stroke and technique instruction at the North Chevy Chase Swimming Pool for members of the North Chevy Chase Sharx Swim Team. All classes are a half hour long and are limited to no more than six swimmers of similar swimming skills. Each swimmer will attend 10 classes, two per week, either Monday and Wednesday or Tuesday and Thursday, beginning Monday, June 18, and ending on Thursday, July 19. The fee is $120. Please make check payable to Tollefson Swimming. Please indicate your first and second choices below for day and time. Skill level, class availability, and the number of swimmers registering will determine exact class placement.

Name of Swim Team Member_______________________________________________

Address_________________________________________________________________

Date of Birth___________________ Home Telephone___________________________

Emergency Telephone Number ______________________________________________

Email address____________________________________________________________

I understand that participation in Tollefson Swimming activities is entirely voluntary. I understand that Tollefson Swimming activities may involve swimming and related pool activities. I know and understand the risks and dangers involved and I know and understand that unanticipated dangers might arise. I hereby release Tollefson Swimming from any responsibility for injury, which might occur as a result of participation in Tollefson Swimming activities.

I give permission for ____________________________ to participate in all Tollefson Swimming activities, except as noted. I also give permission to authorized personnel to carry out such emergency diagnostic and therapeutic procedures as may be necessary for me or my child, and also permit such treatment procedures to be carried out at, and by the local hospital(s) for me or my child in the event of an emergency. I understand that any medical expenses will be billed directly to me or my insurance company.