Signup and Registration Form

After completion of sign-up, please ensure to send payment to either CashApp: $Krystisurvivalswim or
Venmo: @MrsKrystis_Survivalswimschool

Child's Full Name

Child's age

Child's Date of Birth

Parent or Guardian Full Name

Phone Number

Address of Parent or Legal Guardian

Email Address of Parent or Legal Guardian

Additional Emergency contact name

Additional Emergency contact number

Todays Date

I/We have Read & Agree to the Guidelines Policy
Conduct: Children must be seated at all times until their turn. Do not allow them or siblings to play in the water or walk around the pool deck as it greatly interferes with everyone’s concentration, including your child who may be working hard at the time. Your cooperation is greatly appreciated and will add to my own efforts at being efficient and safe as possible. If you allow any child in your care to play on the property, you or your designated agent must take full responsibility for any and all injuries that may occur due to said activity and hold harmless the property owner.
Swim Attire: All children who are not fully potty trained must wear a reusable swim diaper. If you do not have a reusable swim diaper your instructor can provide you ONE covered under the registration fee. This helps to eliminate fecal and urine contamination of the swimming pool and deck. Please have your child use the restroom at your home before coming to lessons as there may not be on-site restrooms available depending on the location. All students will wear regular swim attire unless otherwise advised by the instructor. Please refrain from using any sunscreen on your child as this makes them very slippery making it difficult for the instructor to keep a grip on them. Lessons are only 10 minutes long and we will ensure your child can be in the shade while waiting.
Diet: Please no food or drink for the student at least 1 ½ hours prior to lessons and no dairy/milk products for at least 2 hours prior to lessons.
Video/Photographs: Video and photography are allowed, however please ask permission of the instructor to confirm if it is an appropriate time.

I/We have Read & Agree to the Payment Policy
A $35 non-refundable annual registration fee is charged for each student to ensure a time slot (may be placed on a waiting list, depending on availability) and covers ONE reusable swim diaper, if needed. Weekly payments of $80 are due on Fridays for the following week of lessons. Payments can be made in the form of cash or check on site or through CashApp, Zelle, or Venmo. A $10 late fee will be applied if not paid by Friday. If payment is not made before the next scheduled lesson, the lesson will be canceled until payment is made. After three cancellations due to nonpayment your time slot will be forfeited, and you will be given a different time slot when one becomes available.

I/We have Read & Agree to the Attendance Policy
Credit/Refunds: Please inform your instructor as soon as possible if your child will miss a lesson for any reason. Weekly fees are not refunded for missed lessons. Only lessons canceled by the instructor or doctor excused will result in a credit on the account which could be used for the next week or future refresher/maintenance lessons in the same calendar year. We ask for a two-week notice for any planned vacations to have lessons excused and keep time slot reserved.
Make-Up Lessons: Make-up lessons will only be given for instructor cancellations. These lessons will be held on Friday or Saturday mornings depending on instructor’s availability. If the instructor is unavailable to do make-up lessons, then the account will be applied with the appropriate credits.
Weather: Unless it is raining very hard or there is lightning, we will swim. Due to the volatile weather in Florida, I will try to have lessons even if it means waiting a few minutes for a local storm to pass. You will be contacted by me if lessons are canceled, so please make sure I have the best way to contact you or other caregivers. You are welcome to call or text me and confirm the lessons, but if I do not answer I may be in the pool.
Illness: For the health and safety of your child and other students, a child with a contagious illness is not permitted to swim. This includes, but is not limited to, a fever over 100 degrees and diarrhea. Please contact me if your child is ill and cannot attend lessons that day.
Timeliness: Students are required to be poolside, dressed, and ready to begin their lesson at the scheduled time slot. My schedule is full; it is not fair to other students to push their time slots back; therefore, if your child is not ready on time, the instruction end time will remain the same, resulting in a shorter lesson for your child.

I/We have Read & Agree to the Liability Waiver Consent
I/We understand that while my/our child(ren) is/are in the water with instructor, Krysti Sias, during swim lessons, the instructor shall be responsible. Therefore, any time my children are not in the water, I or my designated agent shall be completely and totally responsible for their safety and well-being. I/We completely and totally release Krysti Sias for any potential liability for any possible personal injuries suffered by any child I or my designated agent brings to the premises for lessons, while on that premises and in yours and/or your caregiver’s care.

Signature of Parent or Guardian Policy Agreement