Thrive After School Swim Program

Urgent Care Fort Dodge

03 Patients
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Swim Registration

Please read carefully before completing the form below.

Before starting any exercise program, parents should have their child examined by a physician.  Upon allowing my child to participate in the after school swimming program, it is assumed that in the case of a parent's or guardian's absence or unavailability, the REC staff is authorized to arrange for any medical treatment that is considered necessary for the minor child enrolled in the program. 

I grant my child permission to participate in Thrive's After School Swimming Program at the REC.  By signing this consent form, I understand that swimming poses potential hazards as well as transportation to the REC to participate in the swimming program.  Knowing this, I hereby release Trinity Regional Medical Center and the REC's staff from any and all blame should injury occur or property be stolen/damaged while my child participates in this program. 

I understand my child is to be picked up by 4:25 pm as there will be no supervision after this time.  All participants in the program must make a commitment to pick up your child on time.  If there is an extraordinary circumstance, your child must wait at the front desk of the REC.