Suit Up: Swimming For Life LLC - NEW Class Pass Purchase Form

Welcome to Suit Up: Swimming For Life Water Safety & Swim School. Please purchase lesson packages that can be used to redeem swim lessons.

A one-time Registration Fee is required per participant. If there are multiple participants, please fill out this form for each participant.

Student name will be entered below for the membership NOT parent name.

Swimmers who have never taken lessons should purchase an 18 or 24 pack and we recommend they take lessons 3x a week.

Returning swimmers should purchase either a 6 or 12 lesson pack based on whether they will swim once or twice per week.

Lessons are continuous from April - Dec. Additional lessons can be purchased & booked prior to completing your first package.

If you have questions about which package you should select pleases text Coach Cam @ 832-975-0046

Parent/Guardian Name

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You will receive your receipt by email.

First name *

Last name *

Email *

Mobile

STUDENT NAME GOES BELOW

ANNUAL MEMBERSHIP FEE

$25

Please enter the student's name for the membership

✓

You will not be charged if you already have this membership.

Member

First name *

Last name *

Are These Travel Lessons? *

Yes No

Were you approved for 30 minutes lessons? *

If Coach Cam did not specifically tell you to answer yes for 30-minute lessons, then select NO

Yes No

Travel Lesson

PLEASE PURCHASE SWIM LESSON PACKAGE FOR ONE SWIM LESSON PARTICIPANT PER FORM

ex: Fill out form and purchase package for child 1. Come back fill and purchase for child 2.

Travel 18x 20 Minute Lessons $810

18 20 minute Travel Lessons

Travel 24 x 20 Minutes Lessons $1,080

Subtotal $0.00

20 Minute Swim Class Packages

PLEASE PURCHASE SWIM LESSON PACKAGE FOR ONE SWIM LESSON PARTICIPANT PER FORM

ex: Fill out form and purchase package for child 1. Come back fill and purchase for child 2.

24 Class Package $840

24 Private Lessons

18 Class Package $630

18 Private Lesson Package

12 Class Package $420

12 Private Lesson Package

6 Class Package for lessons $210

6 Private Lesson Package

Subtotal $0.00

30 Minute Lesson Packages

30-Min Lesson package of 6 $312

30-Min Lesson package of 12 $624

30-Min Lessons package of 12

30-Min Lesson packages 18 $936

30-Min Lesson package 18

30-Min Lesson packages 24 $1,248

30-min Lesson packages 24

Subtotal $0.00

Child Name

First name *

Last name *

Gender *

Date of birth *

Release and Waiver of Liability:

1. I hereby warrant that I and/or my child (PARTICIPANT) are:

a. FREE OF ANY MENTAL OR PHYSICAL CONDITION, AILMENT OR INJURY (MEDICAL OR OTHERWISE) WHICH WOULD, IN AND OF ITSELF OR IN CONJUNCTION WITH ANY OTHER CIRCUMSTANCE, INCLUDING BUT NOT LIMITED TO THOSE ACTIVITIES ASSOCIATED WITH THIS ACTIVITY, (i) IMPAIR, PREVENT OR PROHIBIT PARTICIPANTS FROM ENGAGING IN SUCH ACTIVITIES OR (ii) BE AFFECTED, AGGRAVATED OR WORSEN IN ANY WAY AS A RESULT, DIRECTLY OR INDIRECTLY, OF PARTICIPANT’S INVOLVLEMENT IN SUCH EVENT;

b. OF SOUND MIND AND BODY AND NOT UNDER THE INFLUENCE OF ALCOHOL OR ANY ILLICIT OR PRESCRIPTION DRUG OR MEDICATION WHICH MAY IN ANY WAY IMPAIR PARTICIPANT’S ABILITY TO ENTER INTO THIS AGREEMENT OR PARTICIPATE IN THE ACTIVITY, FULLY UNDERSTAND THE RESPECTIVE INTENT AND MEANING OF ALL OF THE TERMS AND PROVISIONS HEREOF AND TO PARTICIPATE IN THE EVENT;

c. ENTERING INTO THIS WAIVER AND RELEASE AGREEMENT VOLUNTARILY, BY PARTICIPANT’S OWN FREE WILL, ACT AND DEED, WITHOUT ANY UNDUE INFLUENCE FROM THE ORGANIZERS OR ANY OTHER THIRD PARTY.

2. In consideration for teaching PARTICIPANT to swim (the ACTIVITY), I hereby RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, and COVENANT NOT TO SUE Suit Up: Swimming for Life LLC and its employees, agents, and representatives, individually (collectively, RELEASEES) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or personal injury, including, but not limited to, illness or death, that may be sustained by PARTICIPANT, or to any property belonging to PARTICIPANT, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES, third parties or
otherwise during the ACTIVITY, whether at Suit Up: Swimming for Life or at my home or another location, and whether PARTICIPANT is in the pool engaging in the ACTIVITY or not. This shall include any time or activity immediately before and after the ACTIVITY from my arrival on Suit Up: Swimming for Life property to my departure or from RELEASEES arrival at my property or our agreed location to the RELEASEES departure.

3. I am fully aware of the risks and hazards connected with PARTICIPANT’S participation in the ACTIVITY or playing around a pool, including the risk of physical injury or disability as the result of such injury, and I am voluntarily participating or allowing PARTICIPANT to participate in the ACTIVITY, and to enter the above-named premises and engage in the ACTIVITY. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained, or any loss or damage to property as a result of being engaged in the ACTIVITY.

4. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damages, judgments, suits, claims cost, attorney fees or costs that they may incur due to PARTICIPANT’S participation in the ACTIVITY, WHETHER CAUSED BY OR CONTRIBUTED TOIN WHOLE OR IN PART by any action or failure to act, negligence, breach of contract or other misconduct on the part of the RELEASEES or otherwise.

5. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damages, judgments, suits, claims cost, attorney fees or costs that they may incur while on my property or on property I have designated for participation in the ACTIVITY, WHETHER CAUSED BY OR CONTRIBUTED TOIN WHOLE OR IN PART by any action or failure to act, negligence, breach of contract or other misconduct on the part of the RELEASEES or otherwise.

6. I further accept responsibility for an shall cover the cost to remedy any damage to RELEASEES personnel or property that they may incur while on my property or on property I have designated for participation in the ACTIVITY, WHETHER CAUSED BY OR CONTRIBUTED TOIN WHOLE OR IN PART by any action or failure to act, negligence, breach of contract or other misconduct on the part of the RELEASEES or otherwise.

7. PARTICIPANT agrees that the RELEASEES are authorized to secure appropriate medical attention for PARTICIPANT in the event of an accident, illness or injury on or near the premises while participating in the ACTIVITY or otherwise. PARTICIPANT shall be responsible for any and all costs of medical coverage and treatment provided not covered by PARTICIPANT’S insurance.

8. PARTICIPANT further agrees that the RELEASEES shall have the right to record, broadcast and otherwise exploit in any and all media throughout the world PARTICIPANT’S name, likeness, voice and biographical information as recorded while PARTICIPANT is engaged in the ACTIVITY or otherwise on the property.

9. It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse (if any), if I am alive, and my heirs, assignees and personal representative, if I am not alive, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, and COVENANT NOT TO SUE the above-named RELEASES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be constructed in accordance with the laws of the State of Texas.

10. If any provision of this Waiver shall for any reason be held invalid or unenforceable, such invalidity or unenforceability shall not affect any other provision hereof and this Waiver shall be construed as if such invalid or unenforceable provision were omitted or amended to be made enforceable.

11. I understand that the RELEASEES will not be responsible for any medical costs associated with any injury.

IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I HAVE READ THE FOREGOING WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT, I UNDERSTAND IT AND SIGN IT VOLUNTARILY AS MY OWN FREE
ACT AND DEED, THAT NO STATEMENTS OR INDUCEMENTS, APART FROM THE FOREGOING WRITTEN AGREEMENT, HAVE BEEN MADE; AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT; AND I EXECUTE THIS RELEASE, ON BEHALF OF MYSELF OR MY CHILD UNDER THE AGE OF 18, FOR FULL, ADEQUATE, AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY THE SAME.

I read and accept *

Please read and scroll to the bottom to accept.

SOCIAL MEDIA RELEASE

I hereby grant Suit Up: Swimming for Life LLC and its employees, agents, and representatives (“SuitUp”) the irrevocable right and permission to use photographs and/or video recordings of me and/or my minor child(ren) in SuitUp’s or its partners’ or affiliates’ social media, website, emails, publications, promotional flyers, educational materials, derivative works, or for any other lawful purpose without acknowledgment, payment, royalties, or compensation to me or my child(ren).

I understand and agree that such photographs and/or video recordings of me and/or my child(ren) may be placed on the Internet and may be shared by third parties. I also understand and agree that I and/or my child(ren) may be identified by name and/or title in printed, Internet or broadcast information that might accompany the photographs and/or video recordings of me and/or my child(ren).

I also understand that such photographs and/or video recordings may be taken at and include visuals of my home if I elect to have contract SuitUp’s services to be performed at my home; provided, however that SuitUp shall use best efforts to ensure that no address or other location-specific information is displayed in published photographs and/or video recordings.

I agree that all such portraits, pictures, photographs, video and audio recordings, and any reproductions thereof, and all plates, negatives, recording tape and digital files are and shall remain the property of SuitUp and shall not be returned or delivered to me or my child(ren).

I authorize SuitUp to edit, enhance, crop, alter, copy, exhibit, publish, or distribute this content and waive the right to inspect or approve the final product. I further acknowledge and agree that there is no guarantee that any or all of my or my child(ren)’s images or recordings will be used in any media.

I hereby release, acquit and forever discharge SuitUp, its current and former trustees, agents, officers and employees from any and all claims, demands, rights, promises, damages and liabilities arising out of or in connection with the use or distribution of said photographs and/or video recordings, including but not limited to any claims for invasion of privacy, appropriation of likeness or defamation.

I have read and accept *

Please read and scroll to the bottom to accept.