THE WORLD IS 71% WATER YOUR CHILDREN ARE 100% CURIOUS

Safety Around Water Week May 28– May 31, 2019

Register for the Jackson YMCA

FREE Water Safety Program Ages 3-14

PROGRAM INFORMATION The Jackson YMCA’s Safety Around Water week is a free water safety and basic swim skills program for those with little or no swim experience. This program is open to the community. Classes are grouped by age, from 3 to 14 years old. Classes meet every day, Tuesday through Friday. Pre-registration is required. You must register in person at the front desk. Space is limited and participants will be enrolled on a first-come first-serve basis.

Registration Deadline

12pm Saturday, May 25, 2019.

CLASS TIMES

Class 1 Tues (May 28) - Fri (May 31) 4:45pm – 5:15 pm

Class 2 Tues (May 28) - Fri (May 31) 5:30pm – 6pm

Class 3 Tues (May 28) - Fri (May 31) 6:15pm - 6:45pm

AGE GROUPS

Preschool (3 years - 4 years)

Youth (5 years - 6 years)

Youth/Teen (7 years - 14 years)

LOCATION

All classes will be held at the Jackson YMCA. Classes will start in the Board Room and then move to the pool . Please come dressed ready to swim and bring a towel.

This is a FREE program, funded through grants, with support from our Strong Kids Strong Communities

Campaign.

2019 REGISTRATION FORM

Please refer to the class schedule and complete your registration information. All information must be completed in order to be enrolled. Parent Information Parent Name Birthdate

Parent Name Birthdate

Street Address City Zip

Cell Phone Work Phone

E-Mail Address

Emergency Contact Name Phone Participant (s) Information Requested Time (Please Circle) 4:45-5:15 pm 5:30-6 pm 6:15-6:45 pm 1. Participant Name Birthdate Age

Pre Program Survey Questions I know people who enjoy swimming Yes No I would like to improve my swimming skills Yes No I feel safe in the pool Yes No I can easily swim in deep water Yes No

2.Participant Name Birthdate Age Pre Program Survey Questions I know people who enjoy swimming Yes No I would like to improve my swimming skills Yes No I feel safe in the pool Yes No I can easily swim in deep water Yes No

3. Participant Name Birthdate Age

Pre Program Survey Questions I know people who enjoy swimming Yes No I would like to improve my swimming skills Yes No I feel safe in the pool Yes No I can easily swim in deep water Yes No

I agree that the Jackson YMCA is not responsible for any personal injuries or losses sustained by me and or my child/ren while on the YMCA premises, or as a result of any YMCA sponsored activities. I further agree to indemnify and hold harmless the Jackson YMCA from any claims or demands arising out of any such injury or loss. I hereby give consent that the YMCA may take photographs, slides and/or videotapes of my family and/or me without compensation as may be needed for its records or for promotional purposes such as brochures, newsletters, advertisements and the Jackson YMCA website. Signature Date

127 W Wesley St., Jackson MI, 49201 517.782.0537 JacksonYMCA.org