- LEARN2SWIMSAFE Registration Form
- Please DO NOT let your child have anything to eat or drink 15 minutes prior to a lesson.
- Please DO NOT allow your child to eat a full meal 1/2 hour prior to a lesson.
- Please give your child a snack or a light meal 1/2 hour - 1 hour prior to a lesson ... (preferably no milk nor milk products or anything very acidic).
- NOT FOLLOWING THESE rules may result in your child being very uncomfortable during and after swim lessons or your child getting sick / throwing-up resulting in delaying lessons to a halt for 24 hours.
- Please have your child drink 1 ounce of gator-aide per year of child after each swim lesson. Please ask your child's pediatrician for approval and medical advise about gator-aide and also about the use of ear-drops (such as swimmer's ear or a home-made solution of 1/2 alcohol and 1/2 vinegar) after each swim lesson (which I recommend).
- A. "We will swim as scheduled"
- B. “Lessons are canceled due to bad weather”
- C. “Lessons are running...15 minutes late...” (or other).
- D. Pre-recorded, no specific message. (In this case, lessons will be as scheduled).
- There is little time to speak any concerns with the instructor during lesson time; keep in mind there are lesson immediately following your child's lesson. The instructor is always available by phone or by email later in the evening for any concerns not addressed at the pool.
- Please notify your instructor immediately if your child throws up after your instructor leaves or if your child has diarrhea of a greenish color.
- During the swim lesson, I need to have your child’s total attention and your child needs to know that I am in charge.
- Please do not offer help, encouragement, advise or even praise during the lessons. But please do offer lots of praise after the lesson!
- The steps/stairs are NEVER an Exit, when in the pool, whether for lessons or for fun, your child needs to exit the pool where he / she is finished swimming. We will exit at all different places to reinforce the idea that he / she can get out at any point; that he/ she doesn't need to go to the steps to get out.
- From now on, He / she is to WAIT to get in the pool. WAIT until a supervising adult, i.e. mom, dad, grandma, grandpa, teacher, etc. says "o.k. go" or "ready, go" or "1,2,3, go" THESE are our KEY words we will use EVERY TIME he gets in the pool. Please follow these key words yourself and tell all that are also involved in taking your child swimming to follow these key words.
- During your practice time and after lesson: LOTS of PRAISE when he / she accomplishes any skill we are working on or makes an effort.
- HELP, assist only how much he / she needs. Let your child do what they can on their own.
- If your child uses any type of floatation device such as "floaties" (blow-up floatation armband type of device that go on the arms), swim rings, swim tubes, swim seats/boats, puddle-jumpers, or any other type of floatation device, especially ones that restrict arm movement or keep the swimmer in a vertical position, and can also give the swimmer a false sense of security, DO NOT allow your child to use during the duration of our swim lessons session (2-6 weeks)and limit the amount of time in vests. If it is a must, then please make sure that your child is without them more than with them (Rule of thumb is: if your child has had a total time of 20 minutes of water/swim instruction in the learn2wimsafe program that week, then the swimmer must not use any floatation device more than 20 minutes that week). These devices keep your child in a vertical position and we are working hard to get your child in a horizontal / prone position with legs up at water level for proper swimming. It is twice as hard to teach students that are accustomed to using these devices than students that have not used them. Allowing your child to use floatation devices during the course of our instruction will vastly slow down our progress or any halt it all together. The best and most acceptable type of floatation device is a coast guard approved life vest, the 2nd is a "Swimmy" that goes around the abdomen only and can adjust to the amount of panels/thicknesses of floatation pads, and third and lastly, a "puddle jumper". Arm band "floaties" are NOT recommended at all.
- Hair must be pulled back into a ponytail or bun to prevent instructor from accidentally catching on to hair and hair getting into swimmer's eye.
- DO NOT ALLOW YOUR CHILD TO GET IN THE POOL PRIOR TO LESSON OR TO SWIM within 30 minutes prior to swim lesson.
- If instructor arrives for a scheduled swim lesson and swimmer is already in the pool swimming, the swim lesson may be forfeited for that day and may NOT be made up.
- It is recommended that for every 10 minutes of instruction that the swimmer receives from this program, there be an additional 2- 5 minutes of "practice" time outside of lessons, for reinforcement. Your instructor will periodically give you "homework" / skills to practice between lessons. Make sure that it is not all "drill" work and that your child has fun in an around the water between lessons. The more that your child will be able to get into the water, not only to "practice" but also to have fun, your child will be able to advance in his/her progress of the Learn 2 swim safe program.
- It is important that you support the philosophy of the lessons in order for your child to be successful at Learn2SwimSafe.
- It is recommended that your child complete 2 rounds (80 minutes x 2) each year, especially infants and toddlers and young beginner swimmers.
- If you follow all the rules and guidelines and do your homework as instructed, your child will either be floating or falling in and getting the wall on his / her own at the completion of 80 minutes total time in water in the Learn2SwimSafe Program!
- SWIM LESSON NOT GUARANTEED TO ALWAYS BEGIN ON TIME! Your lesson time is not an exact time but is an estimated time, due to the fact that each swimmer's swim time ranges in time. Always allow 20 minutes leeway either way due to my previous lesson going overtime/under-time, and traffic. I will call or text with 10-15 minutes heads up when I am on my way. Please have your child dressed, pottied, and ready to get in the pool BUT DO NOT ALLOW YOUR CHILD TO GET IN THE POOL PRIOR TO LESSON OR TO SWIM within 30 minutes prior to swim lesson.
- I understand that I am to pay a separate $25.00 registration fee to register my child in the learn2swimsafe program and to hold my child's spot and, once the date has been confirmed, this registration fee is NON-REFUNDABLE.
- I understand hat the swim lesson times / sessions are based on in-water time and not on the number of lessons and understand that the number of lessons and the time of each lesson will vary from child to child and from lesson to lesson.
- I understand that if it is ***bad weather conditions*** causing the swim lesson to be canceled, we will be able to make-up the swim lesson with a rain check to be used within 3 months during swim season. ***Bad weather conditions*** include high winds, raining, thunder (even if no lightning is visible), lightning, storm weather alerts in the area, or the pool water temperature is below 78 degrees F.
- I understand that during a swim lesson, if thundering is heard or lightning is seen, we are required to get out of the water and away from the pool, postponing lessons, and we will wait for it to pass for 10 minutes before getting back into the pool and resuming lessons. We will wait for 20 minutes before calling it a 'RAINED OUT" Lesson and we will make-up that lesson.
- I understand that if the instructor is on her way to the scheduled swim lesson and thundering is heard or lightning is seen within a 30 mile radius of the pool location, for a 20 minute period, swim lessons will NOT take place and will be CANCELED, the inductor will not proceed to travel to your lesson and the instructor encourages the swimmer NOT to go in or near the water.
- I understand that if it is within 30 minutes of the time for our scheduled swim lesson and I hear thundering or see lightning, it is my responsibility to call the swim instructor to inform her of these conditions.
- I understand that if the pool temperature is not at last 78 degrees F. or the pool or the pool chemicals have bee altered preventing a safe environment for swim (such as the pool has been shocked within the last 24 hours) I am to inform the swim instructor and do so with as much notice as possible.
- I understand that there will NOT be a made-up lesson nor will there be a refund for any lessons missed unless the instructor is notified at least 24 hours prior to swim time, and in that case, the missed lesson may be made up within 3 months of the missed lesson. THERE WILL NOT be a monetary refund; NO MONEY will be refunded for any lessons missed or any swim time missed after the lessons have been scheduled and the 3rd lesson has begun and is in progress. The exception to this rule is if there is a family emergency or if my child becomes ill, and in that case, the sick policy will be in affect and I am required to give the instructor at least 2 hours notice prior to our scheduled swim time.
Name of Student Swimmer:
Date of Birth:
Male or Female:
Home phone number:
Address: Street:
City:
Zip:
Father's name:
Father's cellphone#:
Father's place of work:
Father's work phone number:
Mother's name:
Mother's cellphone#:
Mother's place of work:
Mother's work phone number:
Primary Email to use:
Do you send and receive test messages?
May I send you text messages of swim time updates and swim info updates?
If so, which number is best for me to text?
Does student have any allergies or issues or conditions that need to be taken into consideration when swimming or during swim instruction? If so, please explain:
If student is new to the learn2swisafe program / has not had lessons with Lois previously, please briefly explain: 1.) swimmer's prior formal swim lesson experiences and, 2.) current swim level/abilities:
How did you hear about this program?
My child is covered with health insurance company (list company name):
health insurance primary policy holder:
health insurance group policy #:
health insurance policy holder ID#:
My child's PEDIATRICIAN's name:
My child's PEDIATRICIAN's Phone #:
My child's DENIST's name:
My child's DENIST's Phone #:
I release from any and all liability for any injuries or illness, the swim instructor and the owner of the pool, if other than myself. If my child should become ill or injured during swim lessons, requiring my child emergency medical attention, I authorize the swim instructor to contact the necessary medical persons for immediate medical treatment. The physician, medical technician, and swimming instructor are authorized to administer medical treatment necessary for the health and well-being of my child.
Signed (Father):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
Signed (Mother):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
PLEASE CONTINUE TO READ AND SIGN THE ENTIRE FORM WHICH CONTINUES UNTIL YOU SEE *** END OF THE REGISTRATION FORM ****
(2 more sections below to read and sign)
By registering your child in the Learn 2 Swim Safe Program and by signing below, you are acknowledging that you are in full support and cooperation and you will follow the plan, procedures and instructions as directed in the section titled: "Missed Lessons Policy", "NO SHOW", "SICKNESS", BAD WEATHER CONDITIONS", "NO REFUND POLICY", "SPECIAL INSTRUCTIONS" and "COMMUNICATION":
There will NOT be a make-up lesson nor will there be a refund for any lessons missed unless the instructor is notified at least 24 hours prior to swim time, in that case, the missed lesson may be made-up and will be given 3 months to make up the missed lesson (Exception: see sickness policy below). In any case, there will be no monetary refund for any lessons missed.
NO SHOW:
NO SHOW:
In the event that the swim instructor is not notified of your cancellation and arrives at the swim location at the scheduled swim date and you are not there or your child does not swim, it will count as a missed lesson without notice and the lesson may not be made up nor will there be a refund of time or lessons.
If you wish to make up that missed lesson, you will need to pay the one-time lesson fee of $15.00 ($20.00 for out of area), provided the instructor can work the lesson into her schedule.
If you wish to make up that missed lesson, you will need to pay the one-time lesson fee of $15.00 ($20.00 for out of area), provided the instructor can work the lesson into her schedule.
SICKNESS:
Please Notify the instructor if your child has had diarrhea, vomiting, or fever above 100 degrees f. within the last 24 hours. Your child will NOT be given a swim lesson if any of these symptoms occur. These symptoms must have cleared for more than 24 hours before resuming lessons. In this situation, By notifying the instructor with at least 1 hour notice prior to swim time will not count as a missed or now-show lesson and your scheduled lesson will be made up.
BAD WEATHER CONDITIONS:
In the case that it is bad weather conditions*** causing the lesson to be canceled, we will have a make-up lesson or you will get a rain check / credit to be used within 3 months. ***Bad weather conditions include*** high winds, raining, thundering, lightning, or the temperature of the pool water below 78 degrees. If thundering can be heard or if lightning can be seen within a 30 mile radius of the lesson location, for a 30 minute time period, swim lessons WILL be canceled and the instructor will NOT come out to the pool / swim lessons location and the instructor encourages the student not to go near the pool.
NO REFUND POLICY
* After the 3rd lesson in a swim session round (80 minutes), No monies will be refunded, only SWIM TIME CREDIT will be issued to be used within 3 months' time during swim season; there is an expiration date of one year and registration fee and or an monies paid toward swim fee and all swim times are non-refundable and non-retrievable.
OUT OF SIGHT
It is difficult to sit on the side of the pool during these lessons because your little one may be crying and/or reaching up from the pool for you! For this reason, it is required that you be totally out of sight during these lessons, with the exceptions of the first introductory lesson.
LAST LESSON: For swim students that are swimmers / have learned how to swim or back-float, upon the last lesson, the student will be fully clothed with swim suit underneath. The child will practice falling in and back-floating fully clothed.
YOUR RESPONSIBILITY:
call (941) 204-2760 and notify the swim instructor if you hear thunder or see lightning within 30 minutes of your swim lesson time.
YOUR RESPONSIBILITY: 20-30 minutes PRIOR to EACH LESSON:
PLEASE CALL (941) 204-2760. *Listen to recorded message to hear either:
This prevents me from having to call 4-8 different people while driving to a lesson! With the weather changing so rapidly - from beautiful sunny to thunderstorms, I have had to implement this procedure of communication and have found that this method is the most effective and efficient way to do so.
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SWIM LESSON NOT GUARANTEED TO ALWAYS BEGIN ON TIME! Always allow 20 minutes leeway either way due to my previous lesson going overtime, undertime, and / or traffic.
Please call 941-204-2760 20 minutes before your scheduled time to get an update of swim schedule and swim times. This will prevent yourself from wondering if lesson is on time. If the lesson is running late, the instructor will either: A.) notify you by text and / or telephone call or B.) There will be a recording stating the case.
DO NOT EXPECT A CALL or a text, please call 941-204-2760 yourself.
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IT IS CRUCIAL THAT YOU FOLLOW THESE RULES AND GUIDELINES AT ALL TIMES DURING THE COURSE OF OUR SWIM SESSIONS. Not following these guidelines may result in an unsuccessful outcome. In order to make this program a success, all must follow these guidelines at all times. Tell all that are involved in taking your child swimming to follow these RULES and GUIDELINES.
By registering your child in the Learn 2 Swim Safe Program and by signing below, you are acknowledging that you have read the TWO learn2swimsafe websites: http://learn2swimsafe.blogspot.com/
in its entirety and you are in full support and cooperation and you are agreeing to the specific rules listed below:
Signed (Father or legal guardian):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
Signed (Mother or legal guardian):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
____________________________________________
in its entirety and you are in full support and cooperation and you are agreeing to the terms below: * The swim instructor will confirm your final discounted cost with a separate text and/or email.
SWIM FEE:
SWIM FEE:
I understand that the cost for survival focused swim lessons with the Learn 2 Swim Safe program is $100.00 per 80 minutes swim time instruction PLUS $25.00 registration fee. See discounts available (listed below).
I understand that there is an additional $2.00 per trip gas fee charge for JACKSONVILLE Swimmers for swimmers outside of Jacksonville city limits or, for CHARLOTTE or SARASOTA or DESOTA or LEE County swimmers: there is an additional $2.00 per trip gas fee charge for outside of Port Charlotte - for instructor traveling across the Peace River bridge from Port Charlotte, or for instructor traveling across the Myakka River or for instructor traveling North of Toledo Blade.
For S.W. FL. swimmers, there is an additional $4.00/trip fee for swim instructor driving to Lee County, Desota County, or Sarasota County; $5.00 per trip if travel one-way exceeds more than 30 miles from center of Port Charlotte.
I understand that as part of the registration process, that I am also to register my child as a swimmer and request Lois as an instructor on www.isport.com .
I understand that my fee can be reduced by several other means* :
DISCOUNTS (Maximum total reduction is 25%):.
* 5% off for more than 1 swimmer registering for swim lessons at same pool with back-to-back lessons.
* 10% off 2nd, 3rd, 4th SIBLINGS registering for swim lessons at same pool with back-to-back
* 10% off liking learn2swimsafe's Facebook page.
* 10% off Medicaid clients (must show proof)
* 10% off for Teachers (must show proof)
* 10% off for nurses and fire-fighters (must show proof)
* 10% off for reduced lunches clients (must show proof)
* 25% off free lunches clients (must show proof)
* 25% off for Respite care clients (must show proof)
* Maximum total reduction is 25%.
* The swim instructor will confirm your final discounted cost with a separate text and/or email.
* The swim instructor will confirm your final discounted cost with a separate text and/or email.
Signed (Father or legal guardian):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
Signed (Mother or legal guardian):
(Typed Printed name and electronically sent is verification of signature)
Date signed:
******* END OF THE REGISTRATION FORM *******
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