$140 per person + $25 Mandatory American Red Cross Certification Fee + $20 WML Registration Fee Sunday, June 4, 2023, 10:00AM - 4:00PM - JCC of Mid-Westchester JCC of Mid-Westchester, is located at 999 Wilmot Rd., Scarsdale, NY 10583.Class cost*Mandatory American Red Cross Certification Fee*WML Registration Fee*Student Name* First Last Student Date of Birth* MM slash DD slash YYYY Are you over 18?* Yes No Student Phone*Student Email* Parent Phone*Parent Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current Certifications Lifeguard Lifeguard Instructor Water Safety Instructor Waterfront Lifeguard Waterpark Lifeguard Emergency Contact InfoHow did you hear about us? Do you have any special needs or accommodations?Reminders Please remember to bring a laptop computer, bathing suit, a bagged lunch and towels. Please brush up on your swimming skills and refer to the web page for the class you are registering to take and review the pre-course testing skills. If you are registering for a Review class please make sure your LG cert is current and not expired. Terms & Conditions A refund will not be given to anyone who fails pre-course testing or the class. A processing fee of 10% will be taken out of all refunds. Coupon Total $0.00 Credit Card Cardholder Name Card Details By submitting this form, you agree to the following: I am 18 years of age or I am the parent or guardian of a minor taking the class. I hereby acknowledge that any training or demonstration or participation in program may involve certain risks to any participant including, without limitation, injury to person or to personal property. I fully understand these risks and voluntarily wish to have self / minor take the classes indicated above. In consideration of self / minor being permitted to participate in class, I hereby agree to assume all the risks and responsibilities surrounding such participation, including, without limitation, those of injury to person or personal property; and further, for self / minor, my heirs, personal representatives, and assignees. I hereby agree to defend, hold harmless, indemnify, release forever, and forever discharge WML Aquatics and all their trustees, officers, agents, contractors, and employees from and against any and all threatened and imposed claims, demands, and actions or causes of action, on account of damage to personal property, or personal injury which may result from the aforesaid participation and activities incident thereto. Further, it is hereby certified that the above-named participant has no medical or psychological conditions which would preclude such participation. I hereby authorize WML Aquatics through its authorized agents to secure for self / minor any emergency medical treatment that becomes or that may become necessary as a result of participation in class. I acknowledge I have read and understand this information. WML Aquatics will conduct classes in the manner prescribed by the American Red Cross, which has provided guidelines for proper hygiene. Each student will be provided with the use of his or her own manikin and AED equipment for instruction. Instructors will be required to properly decontaminate all equipment between classes. Privacy Policy Your information will not be shared with ANYONE including 3rd parties.
