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Below you can enroll online for our Camp H20. Please fill out all
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Required Fields.
Enrollment for 2018 Holiday Camp H2O
2018 Holiday Camp H2O
December 26-28th 2018 (3 day) camp $195.00
Student Information
Child's Name:
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Date of Birth:
(MM/DD/YYYY)
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Gender
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Male
Female
Parent(s) Name(s):
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Email:
(Receive confirmation of registration)
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Address:
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City:
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State:
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Zip:
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Home Telephone:
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Cell Phone:
Mother's Work Telephone:
Father's Work Telephone:
Emergency Contact:
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Emergency Contact Phone:
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My Child Can Only Be Picked Up By:
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(Children Must Be Picked Up by 5pm every day. Late Fees will apply)
My Child would like to be grouped with the following campers:
Why did you choose us?
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Holiday Camp H20 (December 26-28, 2018) Total Cost:
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$195.00
Medical Information
Does your child have asthma?
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Yes
No
Are the asthma attacks exercise induced?
Yes
No
Not Applicable
Does your child carry an inhaler?
Yes
No
Not Applicable
How frequent are the attacks?
Are there any special health / medical / or dietary conditions with which we should be aware? If none, type "none." Questions? Just give us a call at 770-973-3120.
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(Anything you'd like to tell us...) Comments:
Billing Information
Your billing information below will be processed after we receive and review your camp selections to finalize your booking.
Camp H2O Refund Policy
We Have a 7-day cancellation policy. Please E-mail info@atlantaswimacademy.com at least 7 days prior to the session start date for a full refund minus a $50 processing fee. Include your name, your camper’s full name, and the reason for the cancellation and the office will administer the cancellation. No refunds if withdrawn with less than 7 days’ notice. There are no refunds for missed days of camp. No refund or credit is issued on cancellations made on or after the first day of camp.
Billing Address:
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City:
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State:
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Zip:
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Name on Card
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Credit Card Type
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Visa
MasterCard
Discover
Credit Card Number
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Expiration Date (mm/yy)
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CSC Code
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Electronic Signature:
(Authorizing ASA to charge your card)
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Pool and Facility Rules
To Keep it Safe and Fun for Everyone… Rules for Camp H2O at Atlanta Swim Academy Rules are designed to keep people safe and to allow maximum enjoyable participation in our swim programs. If you have any questions about these rules – or don’t understand the reasoning behind any of them, please call us at 770-973-3120. We expect you to follow the rules as listed: 1. Finish eating breakfast by 8:30am. Campers will begin their day in the pool at about 9:30am, and eating before exercising is never recommended. 2. If your camper is sick, please keep them home. Campers who become ill at camp will be moved to a quiet area and receive the necessary attention until parents can be notified. Every attempt needs to be made to pick up your child as soon as possible to protect the health and well being of your child and others. If your child’s illness prevents them from attending any other days of camp, a doctor’s note must be presented to withdraw and to receive a credit for the camp. NO refunds are given for missed days of camp because of illness. 3. Please inform the counselors of any allergies or medical conditions your camper has. While we take measures to ensure that counselors are informed of medical issues, it is always nice to hear it from the parent, especially if medication must be administered by a counselor in the event of an emergency. 4. We have a zero tolerance policy for aggressive behavioral problems during camp. Aggressive behavior towards other campers will result in immediate removal from the pool. Continual behavioral problems will result in removal from camp. 5. As a precaution we may clear all pools of swimmers during thunderstorm activity. It is at our discretion whether or not we pull campers out of the water until the weather has cleared. Our rule is: If we hear and see it, we must stop until clear. Our pool is triple grounded for extra safety, but we must still err on the side of caution. We cannot predict the weather, so your cooperation is expected and greatly appreciated. 6. Campers cannot be dropped off earlier than 8:30am and must be picked up by 5:00pm. Please escort your child into the building each morning. If you cannot pick up your child from camp, please make arrangements for someone else to pick up your camper and notify us immediately. Children are not allowed to go home with anyone except authorized persons with a valid ID. A late fee of $10 plus $1 per minute will be imposed to the credit card used at the time of registration if campers are not picked up by 5:00pm. 7. We are a NUT FREE camp. Please do not pack any nuts in your child’s lunch. This includes peanuts, tree nuts, almonds, or nut-based product. You may visit our web site (www.atlantaswimacademy.com) at any time to review these rules.
I understand checking this box will serve as my electronic signature to the above agreement.
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I have read & agree to the Pool & Facility Rules.
Participation and Release Agreement
I, acting on behalf of myself, my family members, all other members of my household, all guests or persons employed by me accompanying the above persons, as well as in the capacity as the legal guardian of the children named below, (collectively the “Participants”), hereby release and discharge Wet World, LLC. d.b.a. Atlanta Swim Academy, the owners, officers, directors, employees, agents, successors, legal representatives and assigns from all claims, demands, actions, judgments and executions of any kind, nature and description, including without limitation those arising with respect to or in any way related to any swimming programs or activities conducted by or associated with Wet World, LLC. d.b.a. Atlanta Swim Academy, its facilities and/or any facilities used by Wet World, LLC. d.b.a. Atlanta Swim Academy (collectively, the “Programs”), whether arising out of past, present, or subsequent events, whether known or unknown, without regard to the cause or causes thereof or the negligence or gross negligence of any party or parties, including that of Wet World, LLC. d.b.a. Atlanta Swim Academy. The Participants agree to protect, defend, indemnify and hold harmless Wet World, LLC. d.b.a. Atlanta Swim Academy from and against any and all liability, loss, damage or expense, including reasonable attorney’s fees, Wet World, LLC. d.b.a. Atlanta Swim Academy may suffer or incur as a result of any claims, demands, costs, litigation, injury to persons or property, death or judgment against Wet World, LLC. d.b.a. Atlanta Swim Academy of every kind and character by, for, through or on behalf of the Participants, without limit and without regard to the cause or causes thereof or the negligence or gross negligence of any party or parties, including Wet World, LLC. d.b.a. Atlanta Swim Academy, with respect to the Programs. I hereby represent and warrant that I have legal authority to act on behalf of the Participants and to legally bind the Participants to the terms of this Agreement. I have noted on the Registration Form on the back of this Agreement any and all medical history or other information of which Wet World, LLC. d.b.a. Atlanta Swim Academy should be aware that would or could affect participation of any of the Participants in the Programs. The Participants hereby authorize Wet World, LLC. d.b.a. Atlanta Swim Academy to treat any Participants in any medical emergency arising during or incident to the Programs. It is expressly agreed that all programs and activities and use of all facilities shall be undertaken at the Participant’s own risk, and the Undersigned represents that each of the Participant(s) is physically able to undertake any and all programs and activities provided. Wet World, LLC. d.b.a. Atlanta Swim Academy shall not be liable for any claims, demands, injuries, damages, actions, or causes of action whatsoever to any Participant or property arising out of, or connected with the use of any of the services and/or facilities. Each of the Participants does hereby expressly forever release and discharge Wet World, LLC. d.b.a. Atlanta Swim Academy from all such claims, demands, injuries, damages, actions or causes of action, and from all facts of active or passive negligence on the part of Wet World, LLC. d.b.a. Atlanta Swim Academy, its officers, directors, employees, agents, successors, legal representatives, and assigns. The Undersigned represents that he/she is familiar with the facilities of Wet World, LLC. d.b.a. Atlanta Swim Academy and the limitations and behavior of each minor child Participant, and shall be solely responsible for the supervision and safety of each minor child Participant named above. This signed Participation and Release Agreement is valid for all classes held at Atlanta Swim Academy. Atlanta Swim Academy often takes pictures and videos of participants for our website photo gallery and program promotion via print ads or social media. You grant permission to use pictures and videos containing you/your child(ren) when you register.
I understand checking this box will serve as my electronic signature to the above agreement.
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I have read & agree to the Participation and Release Agreement.
Photo/Video Release
PHOTOGRAPHY: Atlanta Swim Academy often takes pictures and videos of participants for our website photo gallery and program promotion via print ads or social media. By signing below, you understand and grant ASA permission to use pictures and videos containing you/your child(ren), and understand you have no right or claim to the images.
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I have read and agree to the Photo Release
I do not agree to the Photo Release