Swimming Registration for Arbor Swim Club


Participantís name:___________________________________    Age:____________________

Parent/ Guardianís name:______________________________


City:_____________________________  Zip______________________

Day phone:  ______________________ Evening or cell phone: ________________

Who should we call in case of accident?   (1)  ________________________________

(2) _____________________________    (3) ________________________________

Doctorís name:________________________________ Doctorís number:____________

Dentistís name:________________________________ Dentistís #__________________

Session ________________________________          Date ______________________


I verify that all of the above information is true and correct, I understand that until the full payment for the session has been paid (check has cleared bank) that my child is not registered and I understand that by registering for this swimming activity that I am releasing Jeanne and Dave Murray from any liability due to injury or death resulting from participation in this aquatic program, including theft of my belongings during the swimming lesson. *The parent or guardian of each child MUST stay during the entire lesson.

Please sign:__________________________________


 *All guests & children must stay off the pool deck. Only swimming participants may be on the pool deck, and spectators MUST wait on the shaded patio below the pool without interfering with the lesson.  Please sign:_______________________  *For safety reasons no one is allowed to roam in back yard !


Refunds will not be given for days you miss our scheduled lessons because we are holding a place for you.   Any lessons missed due to rain or bad weather/instructor illness/or pool malfunction will be made up on the next Thursday at the same time. Any cancellations must be at least 2 weeks before the session begins to received any refund. No exceptions because we are holding a spot for your child.

Please sign:_____________________________________


Please call about parking procedures. We are requesting that you park on the side streets and walk down a few houses. (****Please do not park on Harrogate Drive!) Thank you.  A $10.00 refund or discount off next session for parents that follow this request.:-) *Drive slowly on our street because there are little children outside at play.  Please arrive dressed in your bathing suit, ready to go, as No changing/restroom facilities are available. Please DO NOT BRING SMALL CHILDREN AS SPECATORS (unless you are able to keep them under control and seated right by you. Everyone needs to go to the rest room before arriving for lessons).


Please sign: _________________________________________


Payment in FULL needs to be received at least one week before the lesson begins.  ________________


Please make checks for the full amount payable to   Jeanne Murray.  Write your childís name and include this registration form in an envelope and mail to:  6225 Harrogate Drive Ė Austin, TX 78759. I will call you to confirm when I have received your Completed registration form and check/


Signature of Parent/Legal Guardian or Participant __________________/ Date:_______


Arbor Swim Club reserves the right to refuse service based on disciplinary, medical, or hygienic reasons.



Down loadable Form

permission form


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This site was last updated 02/02/17