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LIFECYCLE SWIM SCHOOL LESSONS AT RENTED RESIDENTIAL POOLS


Some LifeCycle Swim School swim lessons are held in rented residential pools. This document outlines the responsibilities of the homeowner, LifeCycle Aquatics, and the participant, or legal guardian of the participant.

Homeowner is responsible for the overall maintenance of the pool and deck area as follows.

HOMEOWNER RESPONSIBILITIES:

1. Homeowner is responsible for all water testing, and for all procedures needed to prevent the spread of recreational waterborne illnesses (RWI’s). The homeowner either uses a professional, certified pool maintenance company to care for the pool, or they may maintain the pool themselves.

2. On the day of the lesson, the homeowner will advise instructor if the water is not safe for swimming.

3. Homeowner is responsible for the proper and safe functioning of the pool (including drains, jets, vacuum); as well as for the proper and safe maintenance of the surrounding deck areas.

4. Homeowner has ensured that all chemicals are stored properly and in a designated are.

5. Homeowner has confirmed that pool meets all federal, state and local codes.

6. Homeowner has reviewed their site-specific emergency action plans (EAP) with the instructor.

7. Homeowner has agreed that no other swimmer or pets will be allowed in the pool during class.

8. Restroom facilities are available for student(s) and instructor. Restroom may be inside the home, in a pool house, or an outdoor toilet.

9. Inclement weather and/or lightening will require immediate and safe exit from the pool and deck areas, into the safety of an indoor space for all students, instructor and guardians. We will first aim to leave the property, however the homeowner has agreed to provide this shelter space if necessary.

INSTRUCTOR RESPONSIBILITIES:

10. Instructor has placed safety rescue equipment – such as a life preserver, reaching pole, rescue tube, or buoy, in plain sight and easily accessible.

11. Instructor follows strict enforcement of Red Cross recommended diving restrictions and progressive teaching protocols.

12. Instructor will have a first aid kit accessible during lessons. Commonly stocked items include plastic adhesive bandages, gauze, waterproof adhesive tape, safety scissors, tweezers, ice packs, rubber gloves and absorbent paper towels.

13. The Instructor is a certified Lifeguard, and is trained to administer CPR and first aid.

GUARDIANS / STUDENTS

14. Parent or Assigned Guardian agrees to be on site and on deck, with a clear view of any minor student during all lessons at all times.

15. Guardian is never to leave any minor alone with the instructor.

16. If the client is an adult, no guardian supervision is required.

17. The client should not be on the property before the instructor has arrived.

18. Client shall not ring the doorbell of the house, or attempt to contact the homeowner.

19. Clients shall park on the street, not on private property of the home.

20. Students and guardians may only enter the house for restroom and for emergency shelter.

21. Client will not bring any glass containers into the pool deck area.

21. The Waiver/Release form (separate document) must be signed by client or guardian before any class conducted at our rented pools.

By signing below I understand all points listed above.

Date: September 21, 2023


First Participant's Name

First Name*

Middle Name

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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