2021 Lifeguard Blended Learning Class Registration Form

Complete the form below to register for the 2021 Lifeguard Blended Learning Class at River Edge Swim Club.
Name*
First Last
DOB*
Date Format: MM slash DD slash YYYY
Address*
Street Address City State / Province / Region ZIP / Postal Code
Home Phone*
Cell Phone*
Email*
Enter yout Community Pass or Bond #*
Please enter a number from 001 to 10000000.
Members are require to enter either their Bond # or Community Pass # to verify their membership. Member must be current.
Cost of Course*
- RESC Member - $350.00
- Non-Member - $375.00
Click on either member or non-member to respond. If paying by check, please make check payable to "Cash"
STATEMENT OF UNDERSTANDING
I hereby certify that the information on this form is correct and that I have read and fully understand all course requirements including; the blended learning portion, prerequisites, attendance, refund and cancellation notification as described below. By submitting this form you are either 18 years of age or older, or your parent/legal guardian has read and accepted these terms.
Clicking on the Yes statement indicates that you may not agree with the Statement of understanding but that you have read it.*
- Yes, I have read the statement of understanding.
CANCELLATION NOTIFICATION
In case of inclement weather or other cancellations, we will contact the applicants and advise of the cancelled class/session and reschedule.
CAPTCHA

STATEMENT OF UNDERSTANDING