Parent / Guardian info *

First Name

Last Name

Mobile phone *

(###)

###

####

Billing address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Student info *

First Name

Last Name

Student birthdate *

MM

DD

YYYY

Waiver and release of liability *

I, being the parent/legal guardian of the child named above (the "Student"), on behalf of myself and the Student, voluntarily consent to have the Student attend and participate in Glide Swim School LLC ("Glide") swimming lessons. I am aware of the risks to person and property known to be associated with swimming lessons and domestic swimming facilities including, but not limited to, the dwelling structure, the pool, gates, diving board, steps, equipment, foliage, insects, parking and surrounding areas. I understand that swimming is a potentially hazardous activity and there are risks inherent to swimming that include but are not limited to: injuries, broken limbs, cuts, paralysis, illness and even death. Knowing the risks, and in consideration of the Student participating in swim lessons, I hereby agree to assume all risks related to such participation and hereby further release and agree to indemnify and hold harmless Glide Swim School LLC and its coaches, owners, pool owners, officers, agents and employees from any and all liabilities, claims, demands and causes of action whatsoever arising from, relating to or attributable to any loss, damage or injury, including death, that may be sustained or suffered by Student or Accompanying People (Parent, Guardian, Babysitter, Family, et al.)while participating in, or traveling to or from, swim lessons— including any such liabilities, claims, demands or causes of action arising out of Glide Swim School or its instructors' negligence or gross negligence. I agree to indemnify and hold harmless Glide and its coaches, owners, pool owners, officers, agents and employees from and against any and all damages, costs and expenses (including, but not limited to, costs of any treatment or medical care, reasonable attorneys' fees and court costs) incurred by them arising from any claims, demands or causes of action by or on behalf of the Student (including any claims, demands or causes of action arising out of Glide's or its instructors' negligence or gross negligence). I hereby authorize any representative of Glide to have the Student treated in any medical emergency during his or her participation in swim lessons. Further, I hereby agree to pay all costs associated with medical care and transportation for the Student in connection with any medical emergency. I acknowledge that I have thoroughly read this waiver and release and fully understand that is a release of liability. By signing this document, I am waiving any right I or my successors might have to bring a legal action or assert a claim for and on behalf of myself or the Student against Glide Swim School LLC as detailed in the first paragraph of this Waiver and Release.

Acknowledged, authorized, and agreed

Photo & video authorization *

I authorize Glide Swim School to use photographs and/or video taken of my child(ren) during their swim instruction for use in Glide Swim School training, advertising, and marketing materials including Glide's social media, website, and printed materials.

Yes, I agree

No, I disagree

Policies and Special Notes *

Lesson plans are invoiced fully in advance and payment is due upon receipt. Lessons happen rain or shine, unless there is lightning or flood watch. Glide Swim School reserves the right to cancel all, or any portion of, a swim lesson due to weather or any other reasons within or beyond its control. Lessons canceled by Glide Swim School will be rescheduled at our mutual convenience. Any cancellation made before 24 hours is eligible for rescheduling until the expiration of the purchased package (typically 90 days). Rescheduling availability is not guaranteed. Any cancellation made by students or guardians fewer than 24 hours prior to the start of the scheduled swim lesson will be charged as a completed lesson without rescheduling, refund, or other recompense.

Acknowledged, authorized, and agreed