Climax Aquatic Centre

Swimming Lesson Registration Form

Summer 2017

Please complete this registration form, enclose cash (exact) or a cheque payable to the
Village of Climax (re: Swimming Lessons/Pool Pass) for the full registration fee(s) and
mail it to:
Lauren Kos East
Box 126
Climax, SK SON ONO
Or email your registration to climaxaquaticcentre@outlook.com and send payment
immediately to the above address
Submit your registration for Summer Swimming Lessons by June 30, 2017
If you are registering late, spots will be available on a first come first serve basis
NOTE: you will receive your receipt, which will serve as confirmation, by email. Please
check your inbox or junk mail for your Confirmation Email. If you do not receive an email
by July 5th, please contact LAUREN KOS EAST

The following are lesson dates:

July 10-14, 2017 Level 1-5 (am)

July 17-21, 2017 Animal Levels/ Level 6-10 (am)
August 14-18, 2017 Animal Levels/Level 1-10 (pm)

The following are swimming lesson prices:

Animal Levels $30 with pass, $35 without pass

Levels 1-5 $30 with pass, $35 without pass
Level 6-9 $35 with pass, $40 without pass
Level 10 $40 with pass, $45 without pass

Season Passes:

Child (-5) pass before June 29- $60, after June 29 - $80
Single (+6) pass before June 29- $100, after June 29 - $120
Family before June 29- $200, after June 29 - $250

Please mail a cheque that includes swimming lesson fees AND season pass (if you choose to
purchase a pass for this season).
 Climax Aquatic Centre
Swimming Lesson Registration Form
Summer 2017

Contact Person/Guardian:

Last Name: First Name:

Mailing Address:

Phone Number:: Email Address:

Participant Information:

Last Name: First Name:

Birth Date: Gender:

Please check mark which swimming lesson session(s) you want your child enrolled in:

July 17-21, 2017 July 10-14, 2017

Starfish $____ Level 6 $____ Level 1 $____

Duck $____ Level 7 $____ Level 2 $____
Sea Turtle $____ Level 8 $____ Level 3 $____
Sea Otter $____ Level 9 $____ Level 4 $____
Salamander $____ Level 10 $____ Level 5 $____
Sunfish $____ child (-5) pass $_____ (x__)
Crocodile $____ single (+6) pass $_____ (x__)
Whale $____ family $_____ (x__)

August 14-18, 2017

Starfish $____ Crocodile $____ Level 5 $____

Duck $____ Whale $____ Level 6 $____

Sea Turtle $____ Level 1 $____ Level 7 $____

Sea Otter $____ Level 2 $____ Level 8 $____

Salamander $____ Level 3 $____ Level 9 $____

Sunfish $____ Level 4 $____ Level 10 $____

Cheque Number ______ Cash Total Payment: $______