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Pine Lake Adult Learn to Swim Bootcamp

Columbia Athletic Club > Pine Lake Adult Learn to Swim Bootcamp

Participant Information
Swimmers Name*
First Last
Date of Birth*
Month
Day
Year
Age
Gender:*
- Male
- Female
Swimmer is a:*
- Member
- Non-member
Reservation Request For
Session Dates*
- August 4 – 14, 5:30 – 6:15pm
- August 18 – 28, 5:30 – 6:15pm
Skill Level*
- Beginner 1 (no swim experience, cannot float)
- Beginner 2 (little or no experience with strokes)
- Intermediate (looking to improve technique)
Contact Information
Contact Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Emergency Contact Person*
Emergency Contact Phone*
Comments
Policies and Procedures
Enrollment Procedures
- Submitting this form is confirming your request for the swimmers enrollment into lessons and all indicated session dates.
- Request forms will be sorted by when recieved as well as by Member and Non-member.
- Participants will receive payment receipt and email confirmation upon enrollment.
Cancellation and Refunds
- Cancellation or un-enrollment from future sessions or classes must be received by email.
*
- I understand that this is a registration request form and my enrollment is not complete.
*
- I accept full responsibility for my child's use of any and all apparatus, appliances or facility privilege or service whatsoever, owned and operated by Columbia Athletic Clubs at their own risk and shall hold the Club, its shareholders, directors, officers, employees, representatives, and agents harmless from any and all loss, claim, injury damage or liability sustained or incurred by my child resulting therefrom.
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INSPIRING HEALTHIER LIVES SINCE 1981

Juanita Bay

425.821.0882

MON – FRI

5am – 10:30pm

SAT & SUN

6am – 8pm

Pine Lake

425.313.0123

MON – FRI

5am – 10:30pm

SAT & SUN

6:30am – 10:30pm

Silver Lake

425.745.1617

MON – FRI

5am – 10pm

SATURDAY

7am – 10pm

SUNDAY

7am – 8:30pm

Super Range

425.338.2424

Mon - Sun

8am - 10pm

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