Weekly Summer Swimming

What you need to know:

You will select your child’s swim level below within the form.

Here is a description of what each level entails:

Beginner: Will be allowed in the splash area ONLY.
Intermediate: Will be allowed in the splash area, lazy river, water slides and lily pad areas.
Advanced: Will be allowed in all areas beginner and intermediate swimmers are, plus wave pool

*If your child requires a life jacket, you must select either the beginner or intermediate group.

*The pool has a limited supply of life jackets available. Please send a life jacket or puddle jumper with your child if they need one. Please make sure to write your child’s name on their life jacket or puddle jumper.

What to bring on pool days:

- Wear your swimsuit under your clothes
- Bring a change of clothes
- Bring a towel with your child’s name on it.
- Bring a bag to put wet clothes in.
- Sunscreen (if you haven’t already sent it in) labeled with your child’s first and last name (on a piece of tape)
- Spray sunscreen is best as we can easily apply it to your child. If you send a cream or lotion sunscreen, please know that per MHABC’s Child Protection Policy, they will need to apply it themselves.

*Children will begin swimming the week of June 8th – please send their things in with them prior to that day or on the day of.

*MHABC Staff will supervise during swimming along with the lifeguards.

*Please make sure to label your children’s belongings!! Towel, bag, sunscreen, life jacket.

Summer Swimming

Name

This field is for validation purposes and should be left unchanged.

How many children are you registering for swimming?

Child #1 Name(Required)

First Last

Child #1 Allergies(Required)

Child #1 Swim Level(Required)

Beginner: Will be allowed in the splash area ONLY

Intermediate: Will be allowed in the splash area, lazy river, water slides and lily pad areas

Advanced: Will be allowed in all areas beginner and intermediate swimmers are, plus wave pool

Child #1 Life Jacket(Required)

Does Child #1 require a life jacket?

Yes

No

Child #2 Name(Required)

First Last

Child #2 Allergies(Required)

Child #2 Swim Level(Required)

Beginner: Will be allowed in the splash area ONLY

Intermediate: Will be allowed in the splash area, lazy river, water slides and lily pad areas

Advanced: Will be allowed in all areas beginner and intermediate swimmers are, plus wave pool

Child #2 Life Jacket(Required)

Does Child #2 require a life jacket?

Yes

No

Child #3 Name(Required)

First Last

Child #3 Allergies(Required)

Child #3 Swim Level(Required)

Beginner: Will be allowed in the splash area ONLY

Intermediate: Will be allowed in the splash area, lazy river, water slides and lily pad areas

Advanced: Will be allowed in all areas beginner and intermediate swimmers are, plus wave pool

Child #3 Life Jacket(Required)

Does Child #3 require a life jacket?

Yes

No

Parent Name(Required)

First Last

Parent Email(Required)

Emergency Contact(Required)

First Last

Emergency Contact Phone(Required)

Terms and Conditions(Required)

WEEKLY SWIMMING WAIVER AND RELEASE OF LIABILITY – MHABC SUMMER CAMP

PLEASE READ CAREFULLY BEFORE ACCEPTING. THIS IS A RELEASE OF LIABILITY & WAIVER OF CERTAIN LEGAL RIGHTS.

The use of any facilities, services, equipment or premises by MHABC Summer Camp program, including but not limited to Seashore Water Park at Lebanon Memorial Park (collectively, the "Facilities"), and your child(ren)’s participation in or visit to MHABC Summer Camp program and the various locations visited by MHABC Summer Camp, involve the risk of injury to your child(ren), whether your child’s actions or some other person or circumstance causes it. Specific risks vary from one activity to another and the risks range from minor injuries to major injuries, including catastrophic injuries such as drowning and death. You understand and voluntarily accept these risks and agree that Mental Health America of Boone County the entities listed below, and such parties' respective officers, directors, employees, volunteers, property owners, managers, agents and independent contractors (“Releasees”) will not be liable for any injury (including, without limitation, personal bodily or mental health related injury), economic loss or any other damage (collectively, "Losses") to you, your spouse, child(ren), whether caused by the active or passive negligence of the Releasees or otherwise or by anyone at or using the Facilities, and that the Releasees may not be held liable for Losses resulting from defective products. If there is any claim by anyone for any losses that involves you or your child, you agree to: 1) defend the Releasees against such claim and 2) indemnify the Releasees with respect to any losses arising from such claim to the fullest extent under applicable law.

In addition to the terms above, you represent that your child(ren) are in good physical condition and that there is no medical condition or impairment that might prevent your child(ren) from participating in swimming related activities at their ability level (as indicated by you on the “Summer Camp Swim Form”) or by generally using the Facilities. You further acknowledge that the Releasees have not given you or your child medical advice related to your physical condition and ability to participate. If you have any health or medical concerns now or later, discuss them with your doctor.

CONSENT FOR EMERGENCY MEDICAL TREATMENT

In the event of a medical emergency, the undersigned Parent/Guardian of the Participant(s) listed below, hereby grants authorization to Mental Health America of Boone County, its management, directors and agents, franchisees, its members, associates and employees and owner/operators, to employ any legally licensed physician or health care facility on behalf of the participant, and to direct and/or order emergency medical treatment for the participants when necessary. Each of the undersigned also agrees that neither Mental Health America of Boone County, owner/operators nor any of their respective representatives, shall be liable under any circumstances to anyone for exercising the foregoing authority in the event of an emergency.

I HAVE CAREFULLY READ ALL OF THE ABOVE INFORMATION. I ACCEPT AND ACKNOWLEDGE IT WITH FULL KNOWLEDGE OF ITS CONTENTS AND SIGNIFICANCE. I UNDERSTAND THAT THE INFORMATION HEREIN WILL GOVERN MY RELATIONSHIP AND THE RELATIONSHIP OF ANY PARTICIPANTS WITH Mental Health America of Boone County as it relates to weekly swimming at the Lebanon Memorial Park Pool (Seashore Water Park). MY ACCEPTANCE HERE SUPERSEDES ANY OTHER AGREEMENT, WRITTEN OR ORAL, THAT MAY HAVE BEEN PRESENTED TO ME.

By signing this form, I confirm that I have read and understood the terms outlined above.

I confirm that I have read and understood the terms outlined above.

Signature(Required)

Date(Required)