Swim Registration Form

Swim Lesson Registration

(TO BE COMPLETED BY PARENT/GUARDIAN - one form per child please)

Fleming Island Plantation Location:
Group Lessons, Parent & Tot Group Lessons and Private Lessons are available with our certified staff. Please indicate your choice below. Classes are 30 minutes each unless noted.

Private Lessons (Any Age, Any time): 6 Lessons for $210:
Lessons scheduled at your convenience

Scheduled Group Lessons are done for the season. Lessons are still offered at the Group Rate of 5 lessons for $120 for 2 or more participants.

* Indicates required field

Swimmer's Name: *

Session Choice *

Private Lessons (Scheduled at your convenience) Group Lessons (must include 2 or more swimmers)

Select Preferred Lesson Time *

AM PM

Date of Birth: *

Parent/Guardian Name: *

Phone Number: *

Email: *

Address *

Line 1

Line 2

City

State

Zip Code

Country

List any allergies/health issues *

Other Parental Requirements: *

Youth (under the age of 18):
I (the Parent/Guardian), do hereby grant permission for my child(ren) (under the age of 18) to participate in the above program. Further, I agree to observe all the rules and regulations of Elite Amenities at all times. I am aware that my child(ren) will be in the pool. Elite Amenities employees or volunteers, will not be held responsible for any accidents or injuries occurring during swim lessons. Elite Amenities employees or volunteers will not be held responsible for lost, damages, or stolen items. By signing this waiver, I authorize the staff of Elite Amenities to provide first aid should my child(ren) get a minor injuring during swim lessons. I further authorize the staff to contact “911” prior to contacting me in the event of an emergency. (Parent/legal guardian will be contacted immediately after 911 is contacted.)

I Agree *

Yes

Please initial stating you understand the policy that parents must remain on site for participants under the age of 18 *

Please initial stating you understand the policy that classes will be cancelled due to heavy rain or lightning *

Please initial stating you understand the policy that classes will be held as usual during light rain *

Please initial stating you understand the policy that all lessons are held at the Amenity Center Pool *

Please initial stating you understand the policy that cancellation due to medical excuse requires a doctor's note *

Please initial below stating that you understand that payment is due in full at the time of registration. Payment can be made on-line using the PAY HERE link or through Zelle or Venmo using eliteamenitiesllc@gmail.com. *

I understand that my registration will not be complete until I return to www.eliteamenities.com and confirm payment. (Sign name below) *

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Swim Lesson Registration

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