Join the SummerJets for a summer of swimming in a fun and safe environment. The program is designed for beginner to advanced swimmers who are comfortable in the water and wish to improve stroke technique, learn the four basic competitive strokes, skills for flips turns and diving, and racing. Participate in stroke instruction, aerobic fitness, water safety, relay races and water games. Ages 4-18 **Children must be able to float/survival swim.**
Registration options include:
- Mail registration form and check to: CAJ, PO Box 1131, Chico, CA 95927 by 5/30
- Register 5/23 or 5/30 at PV Pool (Bidwell Jr High) from 4:00-5:00 pm
Program Dates: June 12-July 27
$180 for full 7-week program, or $60 per two-week session
7-week swimmers receive a SummerJets T-Shirt and Team swim cap
Swimmers may attend up to four practices per week
Set your own practice schedule: M-Th 10:30-11:30am @ In Motion Fitness
Swimmer Information
First Name / Last Name / MI / Gender / Date of Birth / T-Shirt Size / Number of Weeks Participating (and Dates)Parent/Guardian Information
Full Name: ______
LastFirstMI
Address: ______
StreetApt/Unit #
______
CityStateZip
Email Address: ______Home Phone: (___) ______
Alternate Email: ______Cell Phone: (___) ______
Emergency Contact Information
Child/Children’s name(s):______
Emergency Contact 1:
Full Name: ______
LastFirst
Primary Phone: (___)______Alternate Phone: (___) ______
Relationship to Child:______
Emergency Contact 2:
Full Name: ______
LastFirst
Primary Phone: (___) ______Alternate Phone: (___) ______
Relationship to Child:______
Does child have any allergies we should be aware of (and medications to go with it) in case of insect sting or snacks brought to pool? : ______
SummerJets Release Form
Parent’s Name:______Date:______Address______City______Zip______Home Phone:______Cell Phone:______
In case of emergency-Contact name:______Phone #:______Doctor’s Name:______Doctor’s Phone:______Minor’s Name:______Birtdate:______Age:______Allergies/Medical Disorders______Minor’s Name:______Birtdate:______Age:______Allergies/Medical Disorders______Minor’s Name:______Birtdate:______Age:______Allergies/Medical Disorders______
Medical Release: As the parent, agency representative, or legal guardian, I hereby give consent to In Motion Fitness to provide all emergency medical or dental prescribed by a duly licensed physician (MD) or dentist (DDS) for the above mentioned minor(s). This care may be given under whatever conditions are necessary to preserve life, limb or well being of my dependant(s). Release and Waiver of Liability, Assumption of Risk, And Indemnity Agreement
I, on my own behalf, and on behalf of all those who are listed as a Member below, including my minor children, and my/their personal representatives, assigns, successors, heirs, and next of kin, and those who are listed as a Guest (hereinafter collectively referred to as "the Releasors") desire to utilize the facilities and services offered at In Motion Fitness by I.B.A.M., Inc. (In Motion Fitness and I.B.A.M., Inc. are referred to hereafter as “IMF”) at IMF’s health studio located in Chico, California (hereinafter referred to as the “Premises”). The Releasors hereby agree - as valuable consideration provided to IMF in exchange for the use of the Premises by the Releasors - that this Release And Waiver Of Liability, Assumption Of Risk, And Indemnity Agreement (hereinafter the “Agreement”) shall apply to all uses of the Premises by the Releasors. The Releasors specifically acknowledge numerous and significant risks associated with exercising, training, or participating in other activities that may occur in, on, and/or around the Premises and voluntarily assume all risks associated with such activities, both known and unknown, whether caused or alleged to be caused by the negligent acts of IMF. The Releasors assume full and total responsibility, for myself/themselves, for such risks including but not limited to, claims based on the following: IMF’s improper maintenance of its equipment (mechanical or otherwise), grounds or facilities; IMF’s negligent instruction or supervision, including personal training, or inadequate security or staffing while any of the Releasors are in, on, or around the Premises; the Releasor’s use of IMF’s facilities (such facilities include, but are not limited to: exercise equipment, locker rooms, sidewalks, parking lots, stairs, pools, whirlpool, spa, sauna, steam room, racquet courts, or lobby area), services, or equipment; and/or slipping or tripping anywhere in or about the Premises. The Releasors also acknowledge that the risks of injuries on or around the Premises further include, but are not limited to: injuries or damage arising from the participation by any of the Releasors or others in supervised or unsupervised activities at the Premises; injuries and medical disorders, including, but not limited to death, heart attacks, strokes, heat stress, sprains, broken bones, and torn muscles and ligaments, among others, arising from exercising or any recreational or related use of any of IMF’s facilities or while participating in any IMF programs or activities; and accidental injuries occurring anywhere in or about the Premises, including its dressing rooms, showers, and other facilities. In consideration of being permitted to enter and use IMF’s facilities for any purpose (including, but not limited to, observation, use of equipment and/or services, or participation in any way, including transportation) the Releasors agree that Releasors do hereby release and hold harmless IMF, its directors, officers, shareholders, parents, subsidiaries, employees, independent contractors, and agents from all liability to the Releasors for any loss or damage. The Releasors, to the full extent permitted under the laws of the state of California, waive any claim or demand based on, or on account of, any physical or mental injury or death to any of the Releasors and damage to property, including theft, sustained by any Releasors, whether caused by the active or passive negligence of IMF or otherwise. The Releasors also agree to indemnify IMF from any loss, liability, damage, or cost that IMF may incur due to the presence of any of the Releasors in, upon, or about the Premises or in any way observing or using any of IMF’s facilities, services, or equipment, whether caused by the Releasor’s negligence or otherwise. The Releasors expressly agree that this Agreement is intended to be as broad and as inclusive as permitted under the laws of the State of California, and that if any portion of this Agreement is held invalid, then it is agreed that the remainder of this Agreement shall continue in full force and effect. Releasors agree that, prior to participating in any activity at the Premises, Releasors will inspect the Premises and all equipment and facilities to be used and if, through such inspection, Releasors determine that anything related to that activity is unsafe, Releasors will immediately advise IMF staff of the unsafe condition and will not participate until this condition is corrected. Releasors acknowledge and agree that IMF is not responsible or liable to Releasors for articles of personal property damaged, lost, or stolen in or about the Premises, including in lockers, or for loss or damage to any property including, but not limited to, automobiles and the contents thereof. Releasors agree not to store any valuable items in lockers and to use lockers solely for temporary clothing storage. I acknowledge that I have carefully read this Agreement and fully understand that it is a release of liability, express assumption of risk agreement, and indemnity agreement. I am aware and agree that, by executing this Agreement, I and all the Releasors are giving up any rights I/they may have to bring a legal action or assert a claim against IMF for its negligence, or for any defective product on the Premises. I represent that I have the actual authority to and do hereby enter into this Agreement on behalf of, and as an authorized agent or parent or legal guardian for, all of the Releasors. I have read and voluntarily signed this Agreement and I further agree that no oral representations, statements, or inducements apart from the foregoing written agreements have been made to me or any of the Releasors. I and the Releasors also further agree to be bound by IMF’s rules and regulations.
I hereby agree to all of the terms of this release and wavier of liability, assumption of risk and indemnity agreement. Parents Name______
Parents Signature______
PO Box 1131, Chico CA 95927
(530) 475-CASA