2011
AMERICAN RED CROSS
CITY OF JACKSONVILLE BEACH
JR. LIFEGUARD PROGRAM
#2 Ocean front Jacksonville Beach, FL 32250
249-9141 or 860-2175
PLEASE READ CAREFULLY BEFORE SIGNING(HOLD HARMLESS AGREEMENT)
I ACKNOWLEDGE THAT A LIFEGUARD PROGRAM IS A TEST OF PHYSICAL FITNESS THAT CARRIES WITH IT THE POTENTIAL
FOR DEATH, OR SERIOUS INJURY. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN THE JR. LIFEGUARD PROGRAM, I
HEREBY WAIVE, RELEASE AND DISCHARGE THE INSTRUCTORS, JACKSONVILLE BEACH PARKS AND RECREATION STAFF,
THE CITY OF JACKSONVILLE BEACH, THE AMERICAN RED CROSS VOLUNTEER LIFESAVING CORPS, THE AMERICAN RED
CROSS, THE COUNTY OF DUVAL AND ALL OF IT’S EMPLOYEES AND AGENTS FROM ALL LIABILITY FOR MY DEATH,
PERSONAL INJURY, PROPERTY DAMAGE OR LOSS, OR ANY OTHER FORM OF LIABILITY. I INDEMNIFY AND HOLD
HARMLESS THE NAMED PERSONS AND ENTITIES FROM ANY AND ALL CLAIMS MADE BY OTHERS AS A RESULT OF MY
ACTIONS DURING THE JR. LIFEGUARD PROGRAM AND IT’S ASSOCIATED ACTIVITIES.
Participant’s Signature
Date
Signature of Parent or Guardian
PARTICIPANT INFORMATION (Must be filled out)
PARTICIPANT’S NAME:
(print)_________________________________________________________________M_________F_________
ADDRESS: _______________________________________________________________________________________
CITY: _________________________________, STATE: ______________________ ZIP: ________________________
HOME: ________________________ WORK: __________________________PARENTS CELL: __________________
AGE: __________________ DATE OF BIRTH: _________________________
(Please check which camp child will be attending)
Checks payable to Jax Beach Jr. Guard
First camp $ 150.00 Each additional camp $125.00 (no family discounts for multiple siblings)
Camps
Ages 9 thru 12 ~June 14-18______ June 28-July 2______ July 11-16_____
Ages 13 thru15 ~June 21-25_____ July 5-9______
All Ages 9 thru 15~July 26-30_____ August 2-6_____
Competition Camps all ages/ July 19-24_______ $125.00 previous campers $75.00
Did your child participate in last year’s camp? Yes_____ No______
EMERGENCY CONTACTS
1. NAME: _______________________________ HOME: ________________________ WORK: ___________________
2. NAME: _______________________________ HOME: ________________________ WORK: ___________________
PHOTOGRAPHIC WAIVER: I________________________________________________________________________
( PARENT OR GUARDIAN, OR INDIVIDUAL ~ PLEASE PRINT)
GIVE MY PERMISSION TO THE CITY OF JACKSONVILLE BEACH, TO TAKE PHOTOGRAPHS. I UNDERSTAND THAT
THESE MAY BE USED FOR PROMOTIONAL MATERIAL BUT WILL NOT BE USED FOR THE PURPOSE OF PROFIT.
JR. LIFEGUARD PROGRAM GUIDELINES
Parents:
1. Due to the strenuous nature of this program and since lifeguards must first learn to be
responsible for themselves before they can be responsible for others the following will apply to
participants of this program.
1. Report to camp ON TIME each day.
2. You must bring a lunch. Do not bring money expecting to buy lunch.
3. Do not litter. Throw your trash away. Remember a CLEAN BEACH IS A HAPPY
BEACH!
4. Appropriate swim attire must be worn and foot coverings such as sandals, sneakers, or
flip flops be worn. Mark all personal gear with a permanent marker. All participants are
responsible for their own possessions. It is recommended that only inexpensive items
be brought each day. Do not bring valuables such as surf boards, cell phones, CD’s etc.
5. Rough play, profanity and in appropriate hand gestures will not be tolerated. KEEP
YOUR HANDS TO YOURSELF.
6. Never take or use any gear or personal items that belong to others without permission.
7. All participants in the program must attempt the activities presented.
8. Sick or ailing children must be kept home until well. The program is not funded to
provide care for non participants.
9. Participants will follow directions and instructions. Safety is paramount. Failure to
follow directions could end in injury.
10. Give instructors your full attention and act quickly when asked to do a task. Disrespect
for other participants and staff will not be tolerated. Expulsion from the program may
occur.
11. Participants must remain with their groups at all times. They will leave only with the
lead counselors permission and an assistant counselors escort.
12. The training room and equipment used will be cleaned and stored properly at the end of
each day. Help from all participants is expected. Various pieces of equipment will not
be touched by participants unless told to do so. Defiance may result in expulsion.
13. You are expected to be polite, courteous and respectful of fellow Jr Lifeguards,
instructors and the general public.
14. We expect you to display good sportsmanship when competing with one another and
with other beaches.
15. Jr Lifeguards represent the City of Jacksonville Beach, the American Red Cross
Volunteer Lifesaving Corp., City of Jacksonville Beach Ocean Rescue Division and the
City of Jacksonville Beach Jr Lifeguard Program, any violation of rules and procedures
will be dealt with accordingly. After parents are notified, participants will be expelled
from the program if negative behavior continues.
PARENT_______________________________ _________________________________
Date_________
Print
sign
CAMPER_______________________________ _________________________________
Date_________
Print
sign
2010
AMERICAN RED CROSS
CITY OF JACKSONVILLE BEACH
JR. LIFEGUARD PROGRAM
$150.00 First Session per child
Each session following $125.00
AGES 9-12
SESSION ONE ~ JUNE 14-18
SESSION TWO ~ JUNE 28-JULY 2
SESSION THREE ~ JULY 12-16
AGES 13-15
SESSION ONE ~ JUNE 21-25
SESSION TWO ~ JULY 5-9
ALL AGES 9-15
SESSION ONE ~ JULY 26-30
SESSION TWO ~ AUGUST 2-6
All AGES COMPETITION CAMPS
JULY 19-24 * Cost of this camp ~ (Competition to be held July 24th)
$125.00 first time camper $75.00 previous session camper
Camp hours
Monday –Friday ~ 9:00am to 4:00pm,
Boys and girls ages 9~12 & 13-15
The 2010 Jr. Lifeguard program is an overview of Ocean Rescue Lifeguard
procedures to insure the public’s safety while visiting our beaches. We offer
instruction in Ocean Rescue, first aid, C.P.R., weather patterns, and environmental
awareness. You will learn how to use Lifeguard equipment such as the rescue tube,
and paddleboards. This is a fun and exciting learning experience.
Must be a good swimmer and comfortable in the ocean.
CHECK LIST FOR PARENTS AND CHILDREN
SUNSCREEN
WATER OR DRINK
LUNCH (in a container ~ no bag lunches)
EXTRA SHIRT FOR CLASSROOM
SUITS TO BE WORN TO AND FROM CAMP
For more information please contact 904/249-9141 (lifeguard station)
Coach George Paugh, cell 860-2175
FREQUENTLY ASKED QUESTIONS
If for some reason you need to contact your child, call the Jr. Lifeguard
headquarters at (904) 249-9141. Your message will be delivered as
quickly as possible.
Jr. Lifeguard classes will be held in all weather and surf conditions.
Activities will be adjusted accordingly.
If your child is on medication or has special medical needs please
promptly inform the camp director.
Due to liability and safety reasons we do not allow any children to
participate that are not enrolled.
Please call for an application and register early to ensure participation.
Camp is for ages 9-12 and 13-15 (age groups alternate weekly)
The Competition camp is for all ages 9-15
Registration forms should be mailed to:
Lifeguard Station
Attn: Jr. Lifeguard Camp/ Coach Paugh
#2 Oceanfront
Jacksonville Beach, FL 32250
Jr. Lifeguard questions can be answered year round at 249-9141