Enrollment Form for South Shore Swimmers
**Please note, the swim program will include groups of both boys and girls together in each swim class.
Please let us know if your student feels especially afraid or nervous about beginning swim classes so that we can share that information with the swim instructors in advance of class.
Swim sessions finish at 4:45pm. Please indicate below if you would like your child released to walk/take public transit home. **Please note, there is no school bus transportation provided for this program.
SWIM SUPPLIES: If you already have a swimsuit for your child, please let us know. Funds are limited, and we need to focus on need for funding extra swim clothing.
We have a small supply of both regular sized swim caps and XL swim caps for long/thick hair. If you feel that your student will need a swim cap, please consider purchasing one in advance as our supplies are limited. We have found them for purchase at Amazon using this LINK.
ACKNOWLEDGEMENT OF RISKS STATEMENT
Program Description: Student participation in Red Cross standard swimming lessons delivered by Seattle Parks Department certified lifeguards and targeted at each child’s abilities and needs at the Rainier Beach CC Pool.
Supervision:
I. Students will be directly supervised by adult chaperones when they assemble in the gym at 3:30 PM, while walking between the school and the community center, and while in locker rooms or on the pool deck.
II. Students will be under the supervision of Seattle Parks and Recreation Lifeguards while engaged in swimming activities on the pool deck or in the water.
III. Unless otherwise authorized, Chaperones will return the students to designated drop off point at the school by 4:45 PM.
I understand that my child’s participation in these swimming lessons is voluntary and may expose my child to some risk(s). I have read and understand the Program Description and Supervision outlined above and authorize my child to participate in these swimming lessons.
I assume full responsibility for any risk of personal or property damages arising out of or related to my child’s participation in these lessons, from assembly time at the school, walking to and from the community center, and while in the community center or the swimming pool while under the supervision of the chaperones or Seattle Parks and Recreation. I understand that for their own safety, children must behave, follow the Code of Conduct, and Parks Department Pool rules, and remain under the direction of the Chaperones.
I further agree to indemnify and to hold harmless Seattle Public Schools (SPS), the South Shore PK-8 PTSA (SSPTSA), and the Seattle Parks and Recreation Department, and any of the individuals and other organizations associated with the South Shore PK-8 PTSA in the provision of these swimming lessons from any claim or liability arising out of my child’s participation in this swim program.
I also understand that participation in these lessons will involve activities off of school property; therefore, neither the Seattle Public Schools, nor its employees nor volunteers, will have any responsibility for the condition and use of any non-school property.
I understand that SPS and SSPTSA are not responsible for my child’s supervision during such periods of time when my child may be absent from supervised activity or supervised by others. Such occasions are noted in the “Supervision” section of this agreement.
I hereby acknowledge that I am the parent and/or legal guardian of the applicant, that I have read and that I understand the above 'ACKNOWLEDGEMENT OF RISKS' statement, and that I accept and will be bound by its terms and conditions on my own behalf and on behalf of the student.
STUDENT CODE OF CONDUCT AGREEMENT
While participating in swimming lessons, I understand that I will be a representative of SPS and the PTSA, and that appropriate standards must be observed. I accept responsibility for maintaining good conduct and abiding by South Shore and Seattle Public Schools Code of Conduct, and the rules of Seattle Parks and Recreation, and the Rainier Beach Community Center and Pool.
Students and Parents, please review and discuss these commitments in order to ensure a safe and fun learning experience for every student:
• I will conduct myself with maturity, courtesy, and respect at all times towards everyone I encounter.
• I will follow directions promptly
• I will make attending my swimming lessons each week a priority to ensure I learn the most I can in each class.
• I will be on time to the meeting point in the school gym to prepare to leave for swimming lessons with the group.
• I will bring my swimming supplies with me each lesson (supplied backpack, swim suit, towel, etc.)
• Before swimming: I will travel with the group to the community center to attend swimming lessons.
• After Swimming: I will travel with the group back to school before being released to walk home or be picked up. I will not leave to go home directly from the community center, unless my parents have provided permission in writing.
• I will pay attention to and respect the instructors and always do my best
• I will ask for permission and wait for permission before leaving the group or leaving the community center.
• All the adults in the program are here to keep me safe. I will listen and obey their instructions. I will talk with one of them if I need Help or my classmate needs help.
• I will use my words to encourage my fellow Sea Dragons so that we can all feel safe, capable and successful.
• I realize my participation in Sea Dragon Swim is a privilege, not a right, and my behavior and attendance may affect my ability to continue participating.
I state that both I and my child have read and agree to abide by the terms and conditions set forth in the Code of Conduct and agree to abide by all decisions made by chaperones, swim instructors and supervisor and others in authority. I agree that PTSA and its chaperones have the right to enforce these rules, standards, and instructions. I agree that my child’s participation in these lessons may at any time be terminated in the light of my child’s failure to follow these rules, or for any reason which PTSA Swimming Program may deem to be in the best interest of a student group, and that my child may be sent home at my own expense with no refund as a result. In addition, chaperones may alter activities to ensure individual and/or group safety.
I hereby acknowledge that I am the parent and/or legal guardian of the applicant, that I have read and that I understand the above 'STUDENT CODE OF CONDUCT’ statement, and that I accept and will be bound by its terms and conditions on my own behalf and on behalf of the student.
MEDICAL AUTHORIZATION
My child is able, with appropriate accommodations, if necessary, to participate in the activities described without creating a safety concern for him/herself or for other participants. Please contact the school to discuss accommodations that may be needed.
I agree to disclose to the PTSA Swimming Lessons Program any medications (over the counter and/or prescription) which I/my child shall or should take at any time during the duration of the lessons, but the PTSA may not accept responsibility for the administration of these medications. This must be completed before 3:30 under the direction of SPS personnel at South Shore.
In the event of serious illness or injury to my child/ward, I expressly consent by my signature to the administration of emergency medical care, if in the opinion of attending medical personnel, such action is advisable. Further, I authorize the chaperones to act on my behalf as parent/guardian of my child/ward while participating in the above-described swim program including the admittance to and release from a medical facility.
I hereby acknowledge that I am the parent and/or legal guardian of the applicant, that I have read and that I understand the above 'MEDICAL AUTHORIZATION' statement, and that I accept and will be bound by its terms and conditions on my own behalf and on behalf of the student.
(If your child does require medication before lessons, please complete and return the form “Authorization For Medication To Be Taken At School”, which is available from the school nurse or on the District website)
Emergency Contact Details
Please provide a different contact that we may call if the parent/guardian contact information provided above cannot be reached, in the case of an emergency.
We NEED volunteers!
Volunteers will be needed to chaperone on Thursdays from 3:25 - 5:00pm. If you can volunteer as a chaperone for 3 or more sessions, your student will have a spot secured in free swim lessons!
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Chaperones will not go in the pool.
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You do not need to sign-up to chaperone all 10 sessions, but we ask that if you can volunteer, please commit to at least 3.
Thank you!
Use this link: Sign-up for Swim Chaperones or email us at swim@southshoreptsa.org.
QUESTIONS???
Please review this page: https://www.southshoreptsa.org/swim
If you still have questions about this program, please contact swim@southshoreptsa.com
We have also provided a space here for you to submit your questions. Thank you!
(Use your cursor to sign your name in the space below)
Thanks for applying to South Shore Swimmers. Your application has been completed and we will reach out to you to let you know if your student got a spot in the program. Please contact us if you have any questions at swim@southshoreptsa.org
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