ONLINE PRINTABLE REGISTRATION FORM

For your convenience, you may print out the form below, fill in the information, and either mail it or drop it by the YMCA. If you have questions, please call Ame Mauney at 324-2858 or email her at amem@ymcacv.org. Before registering, please CLICK HERE to view the swimming requirements, cost, and the session information for both Lifeguard Training and GuardStart.
GL Code: 1-036-1302401
Name: ________________________________________  M   F
Address: ______________________________________
City: ______________ State: ______________ Zip: ______________
Phone Number: _____________________
Level: ______________ Time: ______________ YMCA Member:  Y    N
Mother's Name: ___________________________________
Father's Name: ___________________________________
Emergency Contact: _____________________  Phone: __________
Allergies or Medications: _______________________________


Please indicate which program you are registering for:
Lifeguard Training  _____________ GuardStart ______________


Waiver of Liability - Please read and sign


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