Certification Registration

FAST Swim Program Instructor Registration Form

Thank you for choosing the FAST Swim Program Instructor Training! The goal is to teach you how to be a successful instructor following all FAST Swim Program guidelines. We believe that the use of USCG-approved type III life jackets and no forced submersion for all beginning swimmers will lead to program goals. All instructors are required to be First Aid and CPR certified. Please upload your certification at this time.

First Name

Last Name

Date of Birth

Choose which certification you are applying for

Instructor (16-years of age and older)

Instructor's Aide (Minimum 14-years of age)

Address

Phone Number

Email Address

List any diagnosed medical conditions:

List any medical conditions or special needs which may require modification for participation:

Parent/Guardian Information (if under age 18)

Parent First Name

Parent Last Name

Parent Phone Number

Waiver of Claims for Participants - Signature Required (Signer must be 18 years of age or older)

I hereby give the FAST Swim Program instructor trainer permission for me/my child to participate in the instructor training course. The signature below certifies that all information contained in my/my child's registration is correct and true. My signature also affirms my understanding that my/my child's participation in FAST Swim Program and activities may present some risk or injury. The FAST Swim Program and/or the instructor assumes no liability for injuries or damages that result from my/my child's participation in these programs or activities. I agree to indemnify and hold harmless Fast Swim Program and other program participants from liability that may arise from any risk, injury or death that is claimed to be related to this program or its services.

Medical Release: I authorize the FAST Swim Program instructor to act on my behalf if medical treatment for me/my child is necessary. In the event of illness or injury to me/my child, I authorize the FAST Swim Program and/or instructor to obtain medical treatment for me/my child and authorize medical services to be provided at the expense of the responsible party (Parent/Guardian) identified below.

Signature

Please upload proof of First Aid and CPR Certification.

Select File

Your content has been submitted

An error occurred. Try again later

Our Guarantee

Learn to swim in 12 lessons for ages 5+!

FAST Swim Program Instructor Registration Form

Parent/Guardian Information (if under age 18)

Waiver of Claims for Participants - Signature Required (Signer must be 18 years of age or older)