TOWN OF SARATOGA

2017 Swimming Lesson Registration Information

 

Registration forms for the Town of Saratoga Swim Program can be dropped off at Curtis Lumber 30 Saratoga Street in Schuylerville from 7am-5pm Monday through Friday and Sat. 8am 3pm. Ask for BIG MIKE The free program is for any student in the Schuylerville Central School District. Classes will be conducted in a New York State Health Department approved lake at the Christ the King Spiritual Life Center on Burton Road in the Town of Easton and will be conducted Monday thru Friday in the mornings from July 3 to August 4. Following registration, students will be notified of the time at which their one-half hour long class will be scheduled. Forms should be dropped off by JUNE 23rd

Any questions call Big Mike @ 932-2219 or email mcloughlinmichael@msn.com

 

Registration Form

(Minimum age of 5 years old)

 

Name of Student:___________________________________ Date of Birth: _______________

Name of Parent: _______________________________________________________________

Address: ______________________________________________________________________

_____________________________________________________________________________

Town of Residence ______________________E-Mail Address ____________________________

Home Phone #:_______________________________ Work Phone #:______________________

Emergency Contact:___________________________ Phone # :___________________________

Swimming Level: ________________________________________________________________

Years of Swimming:______________________ Lesson Experience :_________________________

________________________________________________________________________________

Health Concerns/Comments:_______________________________________________________

 

 

Student #2

Name of Student:___________________________________ Date of Birth: _______________

Name of Parent: _______________________________________________________________

Address: ______________________________________________________________________

_____________________________________________________________________________

Town of Residence _____________________E-Mail Address ______________________________

Home Phone #:_______________________________ Work Phone #:______________________

Emergency Contact: ___________________________ Phone #: ___________________________

Swimming Level: ________________________________________________________________

Years of Swimming______________________ Lesson Experience: _________________________

________________________________________________________________________________

Health Concerns/Comments:_______________________________________________________

______________________________________________________________________________

 

Please use the back of this page if you have more than two children that will be participating in the program.