STUDENT Last Name:
First Name(s):
CUSTOMER AGREEMENTS
Please initial:
REGISTRATION
I understand that the annual membership fee ($30.00) is due at time of registration and this fee will be automatically
charged
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to my account every year on 1 day of your membership renewal month ($15 for 2 child, any additional students:
no charge) so long as I have a student enrolled in swim lessons here at KSA. If I have enrolled multiple students,
membership renewal month is based on first student’s membership. This is non-refundable regardless of number of
classes attended.
PAYMENTS
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I understand that monthly tuition is due on the 1 of each month and that all payments will be automatically
charged to my credit/debit/bank account. If paying by check, tuition must be received by the 1st of the month. Monthly
tuition is based on how many classes occur during the month. Once a month is paid for, there will not be any refunds. If
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tuition is not paid by the 7 of the month there will be a late fee of $25 applied to the account. If no payment is
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received by the 10 the student(s) will be withdrawn.
REMAIN ONSITE
For liability reasons, I understand that I must stay onsite for my child’s entire class; KSA does not allow drop-offs. I am
responsible for constant supervision for any minor students or siblings. Minor students and/or siblings are not to be left
alone in the bathroom/changing areas.
MAKE UPS
Every swimmer is entitled to 1 free make-up lesson per month. The office must be notified of an absence at least 24hours in advance to qualify for a make-up lesson. You have 30 days from the reported absence to attend your make-up
lesson. Make-ups must be scheduled the week you want to attend, and cannot be re-scheduled. (Make-up lessons do
not apply for Swim Blitz or promotional offers)
PRACTICE/FAMILY SWIM
Swimmers will also be allowed unlimited Practice Swim Times for multiple missed classes or day-of absence
notifications. An adult must join any student under a Level 3 in the water. For additional practice, these times are
$5/swimmer.
POOL CLOSURE
In the event of a pool closure that results in a cancelled lesson, a make-up class will be made available to you. There will
not be any credits or refunds for a closure.
INSTRUCTORS
KSA cannot guarantee instructors. I understand that a change in instructors is not reason for a refund.
WITHDRAWALS
I understand that written or email request is required to withdraw by the 15th of the month, verbal requests over the
phone or in person will not be honored. Drop requests received after the 15th are subject to a $25 processing fee. Once
the next month has been charged on the 1st there will not be any refunds. No exceptions. If I have not received an
email confirmation of my drop from KSA, I understand that my request did not go through and I will re-submit.
*Pro-rates into the next month may be done with a notification by the 15th
By signing below, I acknowledge that I have read, understand, and agree to abide by these guidelines and policies of
King’s Swim Academy. I understand these policies are subject to change as KSA sees fit.
Signature of Parent/Guardian
Date
STUDENT Last Name:
First Name(s):
WAIVER/RELEASE OF LIABILITY
PLEASE READ CAREFULLY BEFORE SIGNING.
THIS IS A RELEASE OF LIABITLITY AND WAIVER OF CERTAIN LEGAL RIGHTS.
I, the undersigned participant and parent request voluntary participation for a minor to participate in the events,
which are hereinafter referred to as the “activities” sponsored by KING’S SWIM ACADEMY.
I consent to my/minor’s participation in the activities and acknowledge that the minor and I fully understand
my/minor’s participation may involve risk of serious injury or death, including losses which may result not only from
my/minor’s own actions, inactions or negligence, but also from the actions, inactions, or negligence of others, the
condition of the facilities, equipment, or areas where the event or activity is being conducted, and/or the rules of
play of this type of event or activity. I understand that if I have any risk concerns, I should discuss the risks
associated with my participation with the activity coordinators and event staff, before I sign this document and
before any activity begins.
Release – Minor’s Rights:
In consideration of allowing Minor Participant to participate in the activities, I hereby release and hold harmless
KING’S SWIM ACADEMY, the coaches and their members of its board of directors, officers, employees,
volunteers, other participants, and agents (collectively, the “Released Parties”), of and from, and do discharge
and waive, any and all claims, demands, losses, damages, and liabilities that Minor Participant may have or
sustain with respect to any and all damage and/or injury, of any type, arising out of his or her participating in the
activities. I also agree that if any portion of this agreement is held to be invalid the balance, notwithstanding,
shall continue in full force and effect.
Release – Parents’/Guardians’ Rights:
In consideration of allowing Minor Participant to participate in this event, I hereby release and hold harmless the
Released
Parties, of and from, and do discharge and waive, any and all claims, demands, losses, damages, and liabilities
that I may have or sustain with respect to any and all damage and/or injury, of any type, arising from Minor
Participant’s participation in the activities. I also agree that if any portion of this agreement is held to be invalid the
balance, notwithstanding, shall continue in full force and effect.
I certify that my/minor is in good health and have no physical condition that would prevent participation in this
activity. Furthermore, I agree to use my/minor’s personal medical insurance as a primary medical coverage
payment if accident or injury occurs. I consent to emergency medical treatment in the event such care is
required.
Indemnification by Parent/Guardian:
The undersigned parent/guardian further agrees to indemnify, save and hold harmless the Released Parties from
any and all claims, demands, losses, damages and liabilities for indemnities, contribution or otherwise with
respect to any damage and/or injury, of any type, arising from Minor Participant’s participation in the activities. The
undersigned also agrees that this Release and Waiver of Liability, Assumption of Risk and Indemnity Agreement
extends to all acts of negligence by the Release and is intended to be as broad and inclusive as is permitted by
the laws of the State in which the Event(s) is/are conducted and that if any portion thereof is held invalid, it is
agreed that the balance shall, notwithstanding, continue in full legal force and effect.
Print name of Parent/Guardian
Signature of Parent
Date