AGREEMENT FOR PARENTAL SUPERVISION AND RELEASE OF LIABILITY

List*

Participants Name(s)	Date(s) of Birth

The undersigned is either personally taking, has children enrolled to take swimming lessons, or participating in Open swim at Blue Buoy Swim School, Inc.

I am aware that when lessons are being taught, it is extremely difficult or impossible for the instructors to supervise all children at all times. I hereby agree that I shall use extreme caution and will be present to actively supervise my children at all times while on the premises of Blue Buoy Swim School, Inc.

In consideration of accepting me or my child's entry into a swimming program, a program that I accept as having inherent risks, i.e. a risk of slipping on wet decks and the potential risk of drowning, I hereby for myself, or my child, waive and release all rights and claims for damages I or my child may incur against Blue Buoy Swim School, Inc., and it's representatives and / or successors for any and all injuries suffered by myself or my child at any activity sponsored by Blue Buoy Swim School, Inc.

Parent/ Guardian Signature*

Print Name*

Date*

Relationship to student*

MEDICAL RELEASE

Does the student have any known allergies or medical conditions? Please explain.*

Are any of these conditions that we, Blue Buoy Swim School, Inc. and / or its’ employees need to be aware of in teaching your child to swim?*

Yes
No

Please explain.*

By signing this provision I agree that I will not knowingly bring any student to swimming lessons if he or she has an infectious or communicable disease.

Signature*

Date*

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Release Of Liability

AGREEMENT FOR PARENTAL SUPERVISION AND RELEASE OF LIABILITY

MEDICAL RELEASE