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Registration & Medical/Release Form

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I learned about this program through (Please check all that apply):
Swimmer Information:
Swimmer's Medical Information

Please check all that apply:

Aquatic History

Is your child around any of the following at home, with family members, friends, or on vacation?

Has your child ever had an aquatic accident?
Has your child used a floatation device?
Agreement and Authorization

I have discussed and understand the nature of this program. I give my consent to Tatum Morris or any authorized Just Us Swim Kids representative for my child to participate in this program as indicated above. I also agree that any pictures or videos taken of my child while in lessons may be used for future Just Us Swim Kids promotions. By signing this I understand that there are no refunds, for any reason.

Waiver Release Form for Liability/Medical Treatment

Registration is not complete until this form is signed and returned. The participant and family of the participant hold Just Us Swim Kids, their agents, employees, and/or volunteers harmless of any and all liability. I fully understand and release the aforementioned entities of any liability. I hereby authorize any medical treatment, which may be advised while attending lessons. By initialing I am fully aware that if my child does not comply with the swim diaper and feeding requirements I will be fined $500 for any pool closures resulting from any uncontained fecal or vomit accident from my child.

Parental Signature *

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& Receipt

Please note parents are responsible for reading all required forms.

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