Discover & Demo Adaptive Swim Registration Form

Please submit this form with all suplimental documentation to register for this introductory class!

Note: Enrollment is limited to 4 children per hour long class. As a result, spaces will be available on a 1st come 1st served basis. Registrants can only be considered registered when ALL required documentation and payment have been provided. Every child is required to be accompanied in the pool by an adult at a ratio of 1:1 to ensure the safety of all participants.

Please fill out 1 Registration form per child.

Waiver of Liability

• I, the Participant and Parent/Guardian, desire to take part in Kapable x We Aquatics Adaptive Swim Lessons conducted at the Foggy Bottom Balance Gym Swim Pool . I am aware that engaging in these activities carries inherent risks, including the potential for physical harm, loss of life, or damage to property. I acknowledge and consent that I/my child have/has chosen to participate willingly, understanding the associated risks. I confirm that neither I nor my child have any known physical or medical conditions that would impede our ability to take part and have provided a medical letter of permission from my child's pediatrician confirming this information. Furthermore, I confirm that I will be an active participant with my child in this lesson at a 1:1 parent/child ratio to ensure proper safety of all participants at all times.

  In exchange for the privilege of participating in the aforementioned activities, I hereby release and absolve Kapable, NoMo Worries, We Aquatics, Balance Gym, along with all of their employees, volunteers, officers, and representatives ("Releasees"), from any and all claims concerning personal injury, death, or property damage that may arise due to or in connection with my/my child's involvement in these activities. This release of liability shall not apply in situations where such harm is the direct result of intentional misconduct or severe negligence on the part of the Releasees.

• I acknowledge that photographs or images of myself/my child may be taken during the activity. I provide Kapable & NoMo Worries, along with their agents and affiliates, with unrestricted permission to utilize my/my child's name, photographs, or any other documentation of our participation in this activity in any form of broadcast, telecast, or other reports related to the activity for promotional purposes, without any compensation. I signify my consent by placing my initials here.

• I/My minor(s), would like to participate in the WeAquatics/Kapable/NoMo Swimming Program (the “Program”). I am aware of the risks and hazards which may arise through participation in the Program and

  consent to my/my minor’s participation in the Program’s activities. These activities may be of a hazardous nature and may include activities such as swimming, diving, a variety of strenuous

  exercises, physical activities, etc. I acknowledge that I/my minor fully understand participation may involve risk of serious injury, illness or death, including but not limited to drowning, near drowning, paralyzing injuries, brain injuries, slipping on the pool deck and contracting infectious diseases. With the full understanding of the facts, I state that to the best of my knowledge, I/my minor have no medical, physical, or emotional health conditions which would prevent

  participation in the program. I understand that if I have any risk concerns, I should discuss with the WeAquatics/Kapable/NoMo Worries staff prior to signing this Agreement and before any activities begin, the risks associated with participating in the Program. For avoidance of doubt, any and all of my obligations under this Agreement shall apply notwithstanding any discussions that I may have with the WeAquatics/Kapable/NoMo staff related to risks associated with participating in the Program or other topics.

  In consideration of allowing my/my minor’s participation in the Program, I hereby release and hold harmless WeAquatics/Kapable/NoMo and their members of its owners, board of directors, officers,

  directors, employees, successors, assigns, affiliated entities, volunteers, other participants, and agents (collectively, the “Released Parties”), of and from, and do discharge and waive, any and

  all claims, demands, losses, damages, and liabilities that I/my minor may have or sustain with respect to any and all damages and/or injury, of any type, arising out of my/my minor’s participation in the Program or any related activities. I authorize WeAquatics/Kapable/NoMo to have me/my minor treated in any medical emergency occurring while participating in the Program, as determined in

  the sole discretion of WeAquatics/Kapable/NoMo. Furthermore, I agree to immediately pay all costs associated with medical care and transportation upon demand for payment.

  I agree to defend, indemnify, save, and hold harmless the Released Parties from and against any and all claims, demands, losses, damages and liabilities, costs and expenses, including reasonable attorneys’ fees and expenses, of whatever kind of nature arising out of or in connection with my/my minor’s participation in the Program. I also agree that this indemnity extends to all acts of negligence and is intended to be as broad and inclusive as is permitted by the laws of the District of Columbia. If any portion of this Agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Similarly, should WeAquatics/Kapable/NoMo or anyone acting on its behalf be required to incur attorney fees and/or costs to enforce this Agreement, I agree to indemnify and hold WeAquatics/Kapable/NoMo and the Released Parties harmless for all such fees and costs.

  This Agreement shall be governed and construed in accordance with the laws of the District of Columbia. Any claims, legal proceeding, or litigation arising in connection with WeAquatics/Kapable/NoMo or

  the Program will be brought solely in the District of Columbia, and I/my minor consent to the jurisdiction of such courts.

• By Signing this waiver, I affirm that I have read and understand it and agree with its contents.

As the minor’s parent/guardian, I hereby consent to his/her participation in the activity. If my child is injured or becomes ill and neither I nor the other parent/guardian can be reached at the numbers below, I give the Kapable/No Mo Worries/We Aquatics/Balance Gym permission to seek medical attention for my child.

If I, or my child, is unable to attend this swim class for any reason without reasonable notice of 1 full week, I understand that any amount spent to secure our spot in the program will be forefitted.

Add your text

Upon Receipt of a completed registration form, you will be contacted via email with an invoice. Your payment will secure your spot and must be made at least 7 days prior to your selected lesson date.