Swimming Lesson Registration Form Warning message Submission of this form does not guarantee placement in a program. Please only submit a registration during designated registration dates. Your form will not be processed if received via the website prior to the start of registration. Payment MUST be received with form. If you use this web form, bring CASH OR CHEQUE the same day you submit this form. MAKE YOUR CHEQUE PAYABLE TO SPRUCE LODGE POOL. Please indicate on your payment the childs first and last name in order to match with your online submission. Money must be recevied the day you submit this form and not a day later. Confirmation EMAILS will be made just prior to the start of the program. Name Parent/Guardian First Name Parent/Guardian Last Name Address Address City/Town Postal Code Main Contact Number where a message can be left: In the case of cancellations this will be the number called. 2nd Contact #/Home Phone Number Email Session - Select -FallWinterSpring OneSpring Two Summer You can only regsiter for the current session, you cannot register for a future session. If a form is received for a session that is not currently accepting registrations it will be discarded. Payment Option Payment must be received within 24 hours of submitting this form. Status message A doctors note is required when cancelling from a course. There is a $5.00 administration fee charged for withdrawls. Refunds if withdrawling for reasons other than medical will be evaluated on a case by case basis. Status message Medical History: Is there any medical information or special needs that you would like us to know? Please also indicate wether or not any conditions are life-threatening. Please ensure you tell the instructor the day of the first lesson should any condition be life-threatening as well. Medical History Information Registration form processing I understand my registration form will not be processed until my payment is received. Status message Name Child's First Name Child's Last Name Childs Birthdate Childs Age First Childs Swimming Lesson Level Menu - please choose the level you are registering for - Select -Parent Tot OneParent Tot TwoParent Tot ThreeParent Tot FourPreschool OnePreschool FourSwimmer OnePreschool FivePreschool ThreePreschool TwoSwimmer ThreeSwimmer TwoSwimmer FourSwimmer FiveSwimmer SixSwimmer SevenSwimmer Eight First Choice Day - Select -MondayTuesdayWednesdayThursdayFridaySaturdaySunday First Choice Time Second Choice Day - Select -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Second Choice Time Third Choice Day - Select -N/AMondayTuesdayWednesdayThursdayFridaySaturdaySunday Third Choice Time Status message This section is to be used if you have a second child to register for swimming lessons. If you do not, then skip to the next pertinent info on this form. Name of Second Child Child's First Name Child's Last Name Second Childs Birthdate Second Childs Age Second Child Swimming Lesson Level Menu - please choose the level you are registering for - None -Parent Tot OneParent Tot TwoParent Tot ThreeParent Tot FourPreschool OnePreschool FourSwimmer OnePreschool FivePreschool ThreePreschool TwoSwimmer ThreeSwimmer TwoSwimmer FourSwimmer FiveSwimmer SixSwimmer SevenSwimmer Eight Second Child First Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Second Child First Choice Time Second Child 2nd Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Second Child 2nd Choice Time Second Child Third Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Second Child Third Choice Time Status message This section is to be used if you have a third child to register for swimming lessons. If you do not, then skip to the next pertinent info on this form. Name of Third Child Child's First Name Child's Last Name Third Childs Birthdate Third Childs Age Third Childs Swimming Lesson Level Menu - please choose the level you are registering for - None -Parent Tot OneParent Tot TwoParent Tot ThreeParent Tot FourPreschool OnePreschool FourSwimmer OnePreschool FivePreschool ThreePreschool TwoSwimmer ThreeSwimmer TwoSwimmer FourSwimmer FiveSwimmer SixSwimmer SevenSwimmer Eight Third Childs First Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Third Childs First Choice Time Third Childs Second Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Third Childs Second Choice Time Third Childs 3rd Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Third Childs 3rd Choice Time Status message This section is to be used if you have a fourth child to register for swimming lessons. If you do not, then skip to the next pertinent info on this form. Name of Fourth Child Child's First Name Child's Last Name Fourth Childs Birthdate Fourth Childs Age Fourth Childs Swimming Lesson Level Menu - please choose the level you are registering for - None -Parent Tot OneParent Tot TwoParent Tot ThreeParent Tot FourPreschool OnePreschool FourSwimmer OnePreschool FivePreschool ThreePreschool TwoSwimmer ThreeSwimmer TwoSwimmer FourSwimmer FiveSwimmer SixSwimmer SevenSwimmer Eight Fourth Childs First Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Fourth Childs First Choice Time Fourth Childs Second Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Fourth Childs Second Choice Time Fourth Childs Third Choice Day - None -MondayTuesdayWednesdayThursdayFridaySaturdaySunday Fourth Childs Third Choice Time Status message Please drop off your payment in the mail slot beside the Pool Office. Payment options are cheque or cash. MAKE YOUR CHEQUE PAYABLE TO SPRUCE LODGE POOL. Status message Spruce Aquatic Centre is located at 643 West Gore St. Stratford, Ont. N5A 1L4 Information Line Phone Number: 519-271-2773 Pool Coordinator Phone Number: 519-271-4090 x2282 Website: www.sprucelodge.on.ca Registration form will not be processed until payment is received. I understand that I must bring in payment. I understand that I must bring payment the same day I submit this form. I understand that I should not submit this form until after 12am Monday. Leave this field blank
