Loading...

Guests at a Private Pool


CLIENTS sign this form if they want LIFECYCLE AQUATICS, LLC (DBA LifeCycle Swim School, "The Company") to teach lessons in a private pool that they do NOT own. The homeowner will need to sign a separate form allowing the guest to use the pool for lessons.

This form explains each party's responsibilities: the Homeowner, LifeCycle Aquatics, LLC, and the guest swimmer/guardian of guest swimmer.

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).

2. Homeowner is responsible for the proper functioning of the pool and all safety equipment.

3. Homeowner has placed safety rescue equipment – such as a reaching pole, rescue tube, or buoy, in plain site and easily accessible.

4. By allowing each lesson, Homeowner confirms that all safety equipment is in place, and that the water quality is safe for swimming.

5. Homeowner has ensured that all chemicals are stored properly and secured.

6.Homeowner confirms that pool meets all federal, state and local codes.

7. Homeowner understands that strict enforcement of Red Cross recommended diving restrictions and progressive teaching protocols will be followed.  The depth of the pool will determine if diving is allowed.  If diving is not safe, diving will not be allowed.

8.Homeowner agrees to make restroom facilities available for student(s) and instructor.

9. Homeowner understands that 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. Homeowner agrees to provide this shelter space.

10. Homeowner should review their site-specific emergency action plans (EAP) with the instructor.

11. Homeowner agrees that no pets or other swimmers will be allowed in the pool during class.

12.Teaching equipment brought on site by the instructor is the instructor’s property, and will be clearly labeled.  If any equipment is borrowed or left behind, it should be returned to the instructor.  Includes items such as floatation noodles, diving toys, and balls.

13. Homeowner understands that it’s advisable to 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, bee sting treatment

14.Homeowner understands the parameters of their homeowner’s liability insurance.

15. Homeowner understands and has signed the Waiver/Liability Agreement provided by LifeCycle Aquatics, LLC

16. Diving boards, slides or any other similar equipment will not be used during instruction.


STUDENT OR ASSIGNED GUARDIAN RESPONSIBILITIES

17. The adult student, or assigned guardian for a minor, understands that the general and specific maintenance of the pool is the responsibility of the homeowner, not LifeCycle Aquatics, LLC (DBA Lifecycle Swim School) (known further more at "The Company."

18. The adult student or assigned guardian will arrive with a charged and working cell phone at each lesson.

19.  Guest agrees that they will not bring any glass containers onto the pool deck or into the pool.

20. Assigned guardian agrees to be on deck, with a clear view of any student seventeen years or younger during all lessons at all times.

21. Guardian will never leave any minor student alone with the instructor.

LIFECYCLE AQUATICS (The Company) RESPONSIBILITIES

22. The Company will provide a swim instructor who is lifeguard certified.


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
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*
Check to receive information, news, and discounts by e-mail.
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*

Phone*
Parent or Guardian's Date of Birth*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!