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    2017 SPLASH Program Booklet Final

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    Anonymous 7XjTCrbHC
    The document is a registration form for a safety around water program offered by the YMCA of Darke County. It requests information such as the name, address, phone number, and swimming ability of the child participant. The form also asks for emergency contact information and a parent signature. The program offers classes at both the Versailles and Greenville branches in May-June that teach pool safety, boating safety, and basic swimming and rescue skills. Advanced registration is required for the free, 45-minute classes.

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    © All Rights Reserved
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    2017 SPLASH Program Booklet Final

    Uploaded by

    Anonymous 7XjTCrbHC
    29 views2 pages
    The document is a registration form for a safety around water program offered by the YMCA of Darke County. It requests information such as the name, address, phone number, and swimming ability of the child participant. The form also asks for emergency contact information and a parent signature. The program offers classes at both the Versailles and Greenville branches in May-June that teach pool safety, boating safety, and basic swimming and rescue skills. Advanced registration is required for the free, 45-minute classes.

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    2017 SPLASH Program Booklet Final

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    The document is a registration form for a safety around water program offered by the YMCA of Darke County. It requests information such as the name, address, phone number, and swimming ability of the child participant. The form also asks for emergency contact information and a parent signature. The program offers classes at both the Versailles and Greenville branches in May-June that teach pool safety, boating safety, and basic swimming and rescue skills. Advanced registration is required for the free, 45-minute classes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    29 views2 pages

    2017 SPLASH Program Booklet Final

    Uploaded by

    Anonymous 7XjTCrbHC
    The document is a registration form for a safety around water program offered by the YMCA of Darke County. It requests information such as the name, address, phone number, and swimming ability of the child participant. The form also asks for emergency contact information and a parent signature. The program offers classes at both the Versailles and Greenville branches in May-June that teach pool safety, boating safety, and basic swimming and rescue skills. Advanced registration is required for the free, 45-minute classes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    SAFETY AROUND WATER REGISTRATION FORM

    Registration forms may be mailed or brought into the YMCA of Darke County.
    Please call to confirm receipt of registration form. SAFETY AROUND WATER
    Please PRINT and please fill out one form PER child.
    ALL FIELDS MUST BE COMPLETED IN ORDER TO PROCESS THE REGISTRATION. SWIM SAFELY WITH
    Parent/Guardian Name ______________________________________________________________
    Address _______________________________________ Primary Phone _____________________
    City, State, Zip _______________________________ Email ________________________________
    Parent/Guardian Birthdate _________________
    Emergency Phone__________________
    Childs Name ___________________________________
    Childs Birthdate _____________________________ School ______________________________
    First-time attendee? Yes No
    Current Swimming Ability (check one)
    Nonswimmer Beginner Advanced YMCA OF DARKE COUNTY
    Class offerings for grades K-6 and ages 3-5. Class Time Desired:

    May 30 - June 1 at Versailles Branch June 19 - 21 at Greenville Branch


    VE Branch - May 30 - June 1
    9:00 - 9:45 AM 9:00 - 9:45 AM
    9:45- 10:30 AM
    4:00 - 4:45 PM
    9:45 - 10:30 AM
    10:30 - 11:15 AM Parent & Child*
    GV Branch - June 19 - 21
    4:45 - 5:30 PM 2:00 - 2:45 PM
    5:30 - 6:15 PM 2:45 - 3:30 PM
    6:15 - 7:00 PM Parent & Child* 3:30 - 4:15 PM SPONSORED BY:
    6:00 - 6:45 PM Parent & Child*
    6:45 - 7:30 PM
    7:30 - 8:15 PM

    *(Parent & Child Class: Child must be 3-5 years old, not completed Kindergarten,
    and parent must get in water with child.)
    Langston Graphics, Inc.

    Has your child participated in a YMCA Program before? Yes No


    Are you interested in helping as a volunteer? Yes No
    My child is in good health and may participate. This event is complimentary to all participants grades K-6 and ages 3-5.
    ADVANCED REGISTRATION REQUIRED
    Parent/Guardian Signature Date
    SAFETY AROUND WATER
    Swim Safely With:
    MAKE A SPLASH!
    A fun way for kids to learn CLASS CURRICULUM
    how to be safer around water! Pool Safety
    Backyard Pool Safety
    Boating Safety
    VE Branch - May 30 - June 1 Beach Safety
    Basic Swimming Skills
    GV Branch - June 19 - 21 Basic Rescue Skills

    YMCA OF DARKE COUNTY 45 Minute classes offered on specified dates


    Greenville Branch Versailles Branch No charge to the participant or the participants family
    301 Wagner Avenue 10242 Versailles-SE Road
    Greenville, OH 45331
    Advanced registration required
    Versailles, OH 45380
    Certificate of completion

    Sponsored By:

    Langston Graphics, Inc.

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