11 learn to swim program - arlington echo outdoor ... · arlington echo outdoor education center...
TRANSCRIPT
Application Form
11
Student’s Name Date of Birth
List any Medical Concerns
Previous Swimming Experience (Swim Center, Arlington Echo, etc.)
Student’s Name Date of Birth
List any Medical Concerns
Previous Swimming Experience (Swim Center, Arlington Echo, etc.)
Learn to Swim Program
Course Name Time Offered
Course Name Time Offered
• Remember that openings will be filled on a first-come, first-served basis.• Makecheckspayableto:Anne Arundel County Public Schools• Mailcompletedapplicationandfeeto: Arlington Echo Outdoor Education Center Learn to Swim Program 975 Indian Landing Road, Millersville, Maryland 21108
Course Name Ages 9:00–9:40 9:45–10:25 10:30–11:10 11:15–11:55
Pre-school Level I 3–4
Pre-School Level II 3–4
Introduction to Water Skills (Level I) 5–7
Fundamental Aquatic Skills (Level II)5–7
8–11
Stroke Development (Level III)6–8
8–11
Stroke Improvement (Level IV)
Stroke Refinement (Level V)
Student 1
Student 2
Contact InformationStreet Address City State Zip CodeParent/Guardian Name email address
Day Evening Phone Phone
Number of Additional Students
Cost per student Totals
$55.00 (First Student) $55.00$50.00
Total Enclosed=
Check if additional students are listed on the back
X =
Application Date
12
Student’s Name Date of Birth
List any Medical Concerns
Previous Swimming Experience (Swim Center, Arlington Echo, etc.)
Student’s Name Date of Birth
List any Medical Concerns
Previous Swimming Experience (Swim Center, Arlington Echo, etc.)
Student’s Name Date of Birth
List any Medical Concerns
Previous Swimming Experience (Swim Center, Arlington Echo, etc.)
Course Name Time Offered
Course Name Time Offered
Course Name Time Offered
Student 3
Student 4
Student 5
12
Learn to Swim Program Application continued