Swimming Lesson Registration Form

Child's name *

Age *

Child's name / 1st sibling

Age

Child's name / 2nd sibling

Age

Child's name / 3rd sibling

Age

Parent/Guardian Name *

Parent/Guardian Email *

Parent/Guardian Mobile Number *

Does your child have any allergies, chronic illness, or medical conditions? *

If Yes, specify any medical condition

Afterschool Program Selected *

Preferred Schedule

Schedule is for confirmation

Afterschool Program Waiver & Media Consent *

I accept the Terms and conditions set forth by Amphibious Surf School

I understand that my child will be participating in afterschool program conducted by trained instructors in a safe and supervised environment. I acknowledge that, while safety is a top priority, participation in watersports activities may involve certain risks, including the possibility of minor injury. I hereby release Amphibious Surf School, its coaches, staff, and affiliates from any liability or claims related to injuries or accidents that may occur during the activities. I also understand that missed classes are subject to the school’s rescheduling policies and that payments are non-refundable once the session has commenced. Additionally, I grant permission for photos or videos of my child taken during afterschool activity to be used for promotional or marketing purposes.