MIDDLEBURY COLLEGE SWIM/DIVE LESSONS
REGISTRATION FORM
2012–2013 academic year
~ $10/half hour for one participant, and $15/half hour for two ~
~Sign up by September 24; lessons can start as early as October 1~

Swimming lessons are once again being offered to faculty, staff, alumni, and their children. Last year there was interest in diving lessons as well so this year we are offering those as well. If you are interested in signing yourself or your children up for a half-hour lesson, PLEASE FILL OUT THE REGISTRATION INFORMATION BELOW AND RETURN WITH A REGISTRATION FEE OF $15 AS WELL AS $60 FOR THE FIRST 6 LESSONS, A TOTAL OF $75, PAYABLE TO MIDDLEBURY COLLEGE AND SEND TO NORMA LEDUC. @ MEMORIAL FIELD HOUSE.

Please indicate which time works best for you. Monday or Tuesday they will be 6 weeks in a row. If your instructor is on break you may reschedule that lesson with the instructor to ensure you get your 6 week session. E-Mail Leduc@middlebury.edu . Available instructors will be assigned on a FIRST-COME-FIRST-SERVED basis. In order to register, individuals must be a parent/guardian, spouse, significant other, family member, student or alum of Middlebury College.

PLEASE CIRCLE ONE: FACULTY STAFF ALUMNI

NAME__________________________________DEPT________________ ID#_____________

PARTICIPANT’S NAME____________________________AGE_______GENDER: M F

ABILITY LEVEL: BEGINNER INTERMEDIATE ADVANCE

LAST INSTRUCTOR’S NAME (if you would like to have again):_____________________________

PREFERENCE FOR A MALE OR FEMALE INSTRUCTOR: MALE FEMALE
IF MORE THAN ONE PARTICIPANT

NAME__________________________GENDER____AGE_____ ABILITY____________

NAME__________________________GENDER____AGE_____ ABILITY____________

PLEASE INDICATE IF THE DAY AND TIME YOU WOULD LIKE TO HAVE LESSON SCHEDULED (PLEASE CIRCLE)

MONDAY TUESDAY

3:00-3:30 PM 7:00-7:30 PM 3:00-3:30 PM 7:00-7:30 PM

3:30-4:00 PM 7:30-8:00PM 3:30-4:00 PM 7:30-8:00PM

4:00-4:30 PM 4:00-4:30 PM

 PLEASE SIGN YOU AND/OR YOUR CHILD IN AT THE BEGINNING OF EACH LESSON.

 DO NOT ENTER OR LET YOUR CHILD ENTER THE POOL WITH OUT THE INSTRUCTOR & LIFE GUARD BEING PRESENT.

 PLEASE WAIT IN THE BALCONY AREA/BLEACHERS IF YOU HAVE A CHILD TAKING A LESSON. YOU ARE NOT ALLOWED TO DROP YOUR CHILD OFF AND THEN LEAVE.

 IF YOU CANNOT MAKE A LESSON, PLEASE BE SURE TO CALL YOUR INSTRUCTOR.
 THERE WILL BE A SEPARATE SIGN UP FOR LESSONS PLEASE MAKE SURE YOU SIGN YOUR CHILD IN AS WELL AS THE INSTRUCTOR.

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