Lake of the Pines
2016 Children’s Summer Swim Lessons
Registration Packet
Register by mail, or drop off completed form at the Administration Office located inside the Clubhouse.
Attn: Recreation Department
Lake of the Pines Association
11665 Lakeshore North
Auburn, CA 95602
Sessions begin June 14, 2016
Call the Recreation Department: 530-268-1141 ext. 2015 with questions .
Recreation Coordinator: Nicole Hurd :Email:
Assistant Pool Coordinator: Lisa Huerta: Phone: 530-906-2677 Email :
Pool Office Phone: 530-268-1496
Registration Rules and requirements:
- Group lessons are provided for children 3- 12 yrs. Parent totgroup lessons for children ages 6 months- 3 yrs., upon request. Please contact Recreation Coordinator before submitting this form for details on swim lessons for participants outside of this age group or if you have special requests.
- Enclose payment in full. (A $10.00 service charge will apply for returned checks).
- No refunds will be granted once session has started, or for missed lessons. Contact the Recreation Coordinator if you have any questions or concerns.
- Registrations are only being accepted in the Administration Office located at the Clubhouse facility.Please DO NOT give registrations to swim instructors, pool staff, or lifeguards.
- You must be a member in good standing to register your family member or guest.
- Registrations are due the Friday before the session you are enrolling in. (ex.: You want to sign up for session 1 that starts Tues. June 14th, your registration needs to be received by 5 p.m. in the Administration office no later than Friday June 10th.)
- Registrations will be confirmed by phone or email no later than the Monday morningof the week each session starts. Your lesson is considered confirmed once you turn in your paperwork. We will call if any changes need to be made. Please do not call Administration.
- Members have priority registration times and sessions, member sponsored guests will be added if there is room available and must be in attendance with the sponsoring member. If the member and guest are the children taking lessons and would like to be in the same class, let us know.
- Refer to ‘Swim Lesson Levels’ sheet to determine class descriptions.
- Choose preferred session, preferred time and list an alternate.
- Three students per class for Level I-II. Four students per class for Level III and up.
- HOLD HARMLESS: Please fill out Hold Harmless Waiver upon registration for every swimmer for each session that you are registering for. If you sign up for multiple sessions at once, (which is highly recommended) you will only need one form filled out for all the sessions you wish your child to attend and payment for each session can be made all at once or payment can be received as late as the Tues. of each session.)You can add multiple children on one form providing you are their legal guardian and the medical provider information is the same.
- Please notify Recreation Coordinator one week in advance if you need a special accommodation or lesson adaptation so week can give your child the best swimming experience possible.
- PRIVATE LESSONS: Please Use Private Lesson Registration Form. (Our Swim Lessons Coordinator will contact you to schedule once your Private Lesson Registration form has been received. )
2016LOP Summer Swim Lessons Registration Form
Please submit this Registration form to Administration Offices during business hours. M-F 9-5.
**Call Recreation Coordinator if you can’t make it during these hours. 268-1141 ext 2015.**
Each Sessions runsTuesday through Friday and includesfour, 30min. lessons per session.
Pricing:
Group Instruction Cost: $40.00/Session – Members $55.00/Session – Member-Sponsored guests
Private Instruction Cost: $60.00/Session–Members $75.00/Session – Member-Sponsored guests
Please Print Legibly:
1. Member’s Name______Lot#(required):______
Address ______
Home Phone______Cell Phone ______Email ______
2. Member-Sponsored GuestName:______□ Member-Sponsored Guest
Home Phone______Cell Phone ______Email ______
Participant’s Name / Age / Session Number:1-7 / Preferred Lesson Start Time / Lesson Level
See Lessons Level guide.Assessment will be made on the first day of lessons. If requesting Private please indicate below: / Fee
Child#1-
Child#2-
Child#3-
Child#4-
TOTAL / $
Please include 2nd session choice incase session or class time is full:.
2nd choice: Session#:______2nd choice: Class Start time: ______a.m.
SessionDates: Class Start Times Available:
Session 1: June 14-17
Session 2: June 21-24
Session 3: June 28-July 1
Session 4: July 5-8
Session 5: July 12-15
Session 6: July19-22
Session 7: July26-29
Session 8: August 2-5
Lake of the Pines Association
Hold Harmless Release and Waiver Assumption of Risk:
Lake of the Pines Association is sponsoring the following activity/activities:
2016Lake of the Pines Swimming Lessons
I the parent/legal guardian of the below named hereby acknowledge by signing this document, that my child’s or children’s participation in this activity is voluntary. I am acknowledging to best of my knowledge that my child or children is/are physically fit to participate in this activity. I understand that this activity involves risks and that serious injuries could occur while my child or children is participating in this activity. In addition, if transportation is provided to the activity, serious injuries could occur. Knowing these risks, I want (my child) to participate in this activity.
Name of Participants: #1 ______#2.______
#3.______#4. ______
Name of Parent/Guardian(s): ______Relationship to participant: ______
Participant’s (or Parent’s) Signature (Required) ______Date ______
Name of Regular Physician: ______Phone: ______
Health Insurance Company: ______I.D. # ______
Emergency Contact:
Name ______Relation ______Phone ______
Does the participant have any conditions the instructor should be aware of? If yes please explain:
______
I (on behalf of my child) hereby assume the risk, and hereby waive, release and discharge Lake of the Pines Association, its’ council, officials, employees, agents, sponsors and promoters of this activity, for any and all claims for damages for personal injuries, or claims for any damages to property, which I (my child) or my (my child’s) heirs, assigns, executors or administrators may have or which may accrue to me (my child), arising out of my (my child’s) participation in this activity, including transportation to or from this activity.
I have read the above and understand that important legal rights are being waived.
I also consent to the Association’s use in its brochures and department fliers or any photographs that are taken of me (my child) while participating in the activity.
Name of participant: ______
Signature (required) ______Date: ______
Medical Release:
In the event that I am not immediately available, should the participant suffer a serious or life-threatening injury for which emergency medical treatment may be necessary, I hereby authorize an appropriate employee or representative to engage qualified medical personnel to initiate any necessary treatment or care. In the event of such an injury, it is understood that Lake of the Pines Association, employee or representative will use all reasonable efforts to notify me or the emergency contact listed where practical, prior to initiating medical treatment for any such injury to the participant. Should neither party be available, an employee or representative will contact appropriate medical personnel to initiate the necessary medical treatment.
I hereby give permission to any such physician or other medical personnel to provide such medical treatment which such individual deems medically appropriate.
I understand and agree that I am responsible for all medical care expenses incurred to treat participant’s injuries.
Participant’s (or Parent’s) Signature (Required) ______Date ______
LOP Swim Lessons Level Guide
Parent Tot Lessons
Introduction to Aquatics
Each child must be accompanied in the water by an adult.
Position orientation
Short breath holds
Desensitize rolling over to back
Introduce back floats
Address safety issues
Sing songs
Water play/exploration
Tadpoles: Level 1
Water Exploration
Enter & exit water safely
Breathing & blowing bubbles
Back float with assistance
Front float with assistance
Roll from front to back/ back to front with assistance
Put face in water to retrieve submerged object
Explore arm and hand movements
Explore swimming on front and back with assistance
Goldfish: Level 2
Primary Skills
Back float without assistance
Front float without assistance
Glide on back
Glide on front
Rhythmic breathing on wall
Breathing and blowing with board
Roll from back to front & front to back
Bob with head entirely submerged
Combining arm and leg movement on front and back
Jump in pool and get into back float without assistance
Sea Otter: Level 3
Stroke Readiness
10 bobs blowing every cycle
Introduce side breathing- ear glue
Bubble arm, breathing arm on gutter then on board
Glide on front and back
Kick on back with board
Kick on back in streamline
Lift and glue drill
Jump or seated dive from side
Tread water- intro to breaststroke
Sea Lions: Level 4
Stroke Development
Kick on side with ear to arm
3 kick catch-up with board
3 kick catch-up freestyle
Lift and glue backstroke
Kneeling or stride dive from edge
Treading water for 30 seconds
Introduce butterfly kick/ body roll
Dolphins: Level 5
Stroke Refinement
Catch-up freestyle
Lift and glue backstroke
Breaststroke kick on deck and with board
Breaststroke kick with board- feet up head up, feet around head down
Pull, breathe kick arrow
Press and roll butterfly kick
Stone skipper drill
Three kick one pull butterfly
Standing dive
Treading water for one minute
Swordfish: Level 6
Stroke Proficiency
Catch-up freestyle
50yd. Freestyle rhythmic side breathing
Lift and glue backstroke
50yd backstroke
Feet up head up, feet around head down
25yd breaststroke
Three kick one pull butterfly
25yd butterfly
Dive from side or block
Open turns and flip turn