ROLF PARK POOL
SWIMMING REGISTRATION
(Must live in the City of Maumee corporation limits or Maumee School District to
enroll in our swim lessons. Proof of residency is required.)
PLEASE FILL OUT COMPLETELY
Swimmer's Name:__________________________________________ Date:__________________
Address:_______________________________________
_________________________________
(Number and
street)
(City, State, Zip)
Phone Number:_______________________ Date of Birth:_________________ Age:____________
School Child Attends:_______________________________________________________________
In case of emergency, whom should we contact? __________________________________________
________________________________________________________________________________
(Name, relationship, phone number)
Father's Name___________________________ Mother's Name______________________________
Have you participated in Rolf Park Pool Swim Program before: Yes No
Course Name Completed:_____________________________________________________________
Which class would you like your child enrolled
in?_____________________ __________________
Class
name
(M-Thur. or Sat.)
Which class time? _________________________
Circle one Session: SESSION
1 SESSION 2 SESSION
3 SATURDAYS
*******************************************************************************************
FOR INSTRUCTOR'S USE ONLY
Swim class information on above child
Class___________________________________ Time______________ Session:
_______________
Proof of residency checked? Yes _____ No _____
Initial of Instructor who checked residency: _________________
Note: You must live in the City of Maumee corporation limits or Maumee School district to enroll in our swim lessons.