Welcome to the online PCA Swim Lessons Registration Form. This form is for members only. Please fill out the fields below if you would like to enroll your child in the swim lesson program. You will receive confirmation of enrollment shortly after submitting this form. We look forward to working with you! Membership Number (Your account will be billed after confirmation) Student Name Student Birthdate Male or Female? Parent(s) Name Address City State Zip Phone # Alternate Phone #? E-Mail Address Number of Sessions? Previous Student? Level (not sure?) Time/Days Instructor (Optional) 1st Choice 2nd Choice 3rd Choice 4th Choice Policies and Swim Information · Payment will be billed to your membership account. Confirmation will be emailed or mailed within 3 workdays of receiving your application. Phone confirmations will be made for applications received less than 1 week prior to starting. · No Make Up Classes: There will be no make-ups, credits or refunds given for missed classes unless canceled by PCA Swim School. Make-ups will be held on Fridays if cancelled by PCA swim school. · Lessons are 30 minutes. Lessons will not be split 15/15 minutes unless a safety issue arises. · Refund Policy: Full credit or refunds will be given only if a student is withdrawn from a class 7days PRIOR to the start date of the session. There will be NO credits or refunds given for students who withdraw less than 7 days prior to the session's start date. · We ask parents to please watch from a distance as children usually respond best when they can't see their parents. By submitting this form, I agree that I have read and understand the PCA Swim School Policies and Information.