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Learn to Swim
October 27th
Monday and Wednesday
6:30pm - 7:00pm
8 Lessons = $100
Parent or Legal Guardian
*Name
*Email
*Phone Number
*Street
*City
*State
*Zip Code
Comment!
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Contact Karolina Papiez at
(269) 986-1760
if you have questions about payments.
Swimmer(s)
Number of Swimmers
1
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
1 Program
.
6:30pm - 7:00pm
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
2 Program
.
6:30pm - 7:00pm
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
3 Program
.
6:30pm - 7:00pm
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
4 Program
.
6:30pm - 7:00pm
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
5 Program
.
6:30pm - 7:00pm
*Name
*Date of Birth
*Gender
--- Select ---
Female
Male
*Age
6 Program
.
6:30pm - 7:00pm
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Membership Agreement
I, for myself, my heirs, personal representatives or assigns, do herby waive, release, and discharge club coaches and assistants of Harper Creek swim club, its directors, officers, employees, and agents from liability for any and all claims and damages, including those caused by the negligence of HCSC, resulting in personal injury, accidents or illnesses, and property loss arising from, but not limited to, participation in activities, swim team, classes, observation, and use of facilities, premises or equipment. I agree that this Waiver and Release is also signed by me on behalf of all minor children of which I am the parent or guardian, and on behalf of my guests or anyone gaining entrance to the pool through the use of my membership.
.
I Agree
Registration Total: $
0
Payment Type
.
Cash App ($ChadMWager)
.
Apple Pay (269-339-6114)
.
Cash (PREFERRED)
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