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Pine Lake 2-Week Intensive Lesson Registration

Columbia Athletic Club > Pine Lake 2-Week Intensive Lesson Registration

Participant Information
Swimmers Name*
First Last
Date of Birth*
Month
Day
Year
Age
Gender:*
- Male
- Female
Swimmer is a:*
- Member
- Non-member
Parent is a:*
- Member
- Non-member
Reservation Request For
Session Dates
- SESSION 3: July 22 – August 1
- SESSION 4: August 5 – 15
- SESSION 5: August 19 – 27
Select all sessions you wish to enroll for:
Skill Level
Select One
Session Times
- 10am
- 11am
- 12:15pm
Select all the times you are available for:
Session Times
- 10am
- 10:30am
- 11am
- 12:45pm
Select all the times you are available for:
Session Times
- 10:30am
- 11:45am
- 12:15pm
- 12:45pm
Select all the times you are available for:
Session Times
- 10:30am
- 11am
- 11:45am
- 12:15pm
- 12:45pm
Select all the times you are available for:
Session Times
- 10:30am
- 11:45am
- 12:15pm
Select all the times you are available for:
Session Times
- 10am
- 11:45am
- 12:45pm
Select all the times you are available for:
Session Times
- 10am
- 11am
Select all the times you are available for:
Session Times
- 11am
- 11:45am
Select all the times you are available for:
Contact Information
Contact Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Emergency Contact Person*
Emergency Contact Phone*
Comments
Policies and Procedures
Enrollment Procedures
- Each session is Mon. - Thurs. for 2 weeks. Each class is 30min.
- Submitting this form is confirming your request for the swimmers enrollment into lessons and all indicated session dates.
- Request forms will be sorted by when received as well as by Member and Non-member.
- We will enroll for all Sessions (S3 S4 & S5).
- Member enrollments will process July 15 & 16.
- Non-member enrollments will process July 17.
- When resubmitting your registration you will immediately receive an automated message stating we received your request. If you do not receive this message please contact the Club.
Payment Procedures
- An email confirmation with class level and class time will follow enrollment and payment
- Reminder: Those placed on a waitlist do not receive email confirmation.
Cancellation and Refunds
- Cancellation or un-enrollment from future sessions or classes must be received by email.
- Once session started there will be no refunds.
*
- I understand that this is a registration request form and my enrollment is not complete.
*
- I accept full responsibility for my child's use of any and all apparatus, appliances or facility privilege or service whatsoever, owned and operated by Columbia Athletic Clubs at their own risk and shall hold the Club, its shareholders, directors, officers, employees, representatives, and agents harmless from any and all loss, claim, injury damage or liability sustained or incurred by my child resulting therefrom.
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INSPIRING HEALTHIER LIVES SINCE 1981

Juanita Bay

425.821.0882

MON – FRI

5am – 10:30pm

SAT & SUN

6am – 8pm

Pine Lake

425.313.0123

MON – FRI

5am – 10:30pm

SAT & SUN

6:30am – 10:30pm

Silver Lake

425.745.1617

MON – FRI

5am – 10pm

SATURDAY

7am – 10pm

SUNDAY

7am – 8:30pm

Super Range

425.338.2424

Mon - Thurs

9am-10pm

Fri - Sun

8am-10pm

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