Swim Lesson Registration Form
Sponsored by the Hopkinton Recreation Department
Kimball Pond will open for the season on Saturday June 27th and stay open thru Saturday, August 22, 2009 for all Hopkinton/Contoocook residents. Hours of operation will be 10:00 am to 6:00 pm
All levels of the American Red Cross Progressive Swim Program will be offered at Kimball Pond for children ages 4 years old and up. Each class will cost $40. Lessons are scheduled Monday thru Thursday, with Friday as a make-up day if class is canceled by the instructor.
Child Name _____________________________Home Phone _______________ Date of Birth _________
Address ___________________________________________________________________
Parent/Guardian ____________________________ Work Phone _____________
Emergency Contact _______________________________ Phone _______________
Please check off which Session(s) AND Level you are signing up for
___Session I~: 7/6 -7/17 ___Session II: 7/20 -7/31 ___Session III: 8/3 - 8/14
___Level I: 11:00-11:30 am ___Level I: 2:30-3:00 pm
___Level II: 11:45 am to 12:15 pm ___Level III: 12:30 pm to 1:00 pm
___Level IV: 1:45 pm to 2:15 pm
Cost: $40.00/session X ___ Sessions = Total Enclosed: $____________
Please make checks payable to “Hopkinton Recreation Department”
Level I: Beginning water readiness - primary skills.
Level II: Familiarity with various strokes - secure in floating, kicking and regular~breathing.
Level III: Progression of technique and endurance - development of swimmer self-confidence.
Level IV: Stroke refinement - backstroke, breaststroke, front crawl and butterfly.
I hereby release the Town of Hopkinton, its employees and agents, from any liability for personal injury, loss or damage to personal property, which my family may experience in connection with the American Red Cross Swimming Lessons, sponsored by the Hopkinton Recreation Department. I hereby consent to any medical procedures deemed advisable for my child in the event I cannot be reached and my child has sustained physical injury.
Parent Signature ____________________________________ Date ______________
Please mail or drop off form and check to:
Hopkinton Recreation Department 330 Main Street Hopkinton NH 03229
746-2915
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