2017 American Red Cross SPAR / Registration Form

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1 2017 American Red Cross SPAR / Registration Form Participant s Legal Name Mailing Address City State Zip Best Phone Alternate Phone Text [ ] Yes [ ] No Age Date of Birth / / Parent/Legal Guardian Phone [ ] March Weekend Class March 18, 19, 25, 26 Registration Deadline: Tuesday, March 14 [ ] April Weekend Class April 1, 2, 8, 9 Registration Deadline: Tuesday, March 28 [ ] Spring Break Class I April 15, 17, 18, 19 Registration Deadline: Tuesday, April 11 [ ] Spring Break Class II April 20, 21, 22, 23 Registration Deadline: Monday, April 17 Classes Might Fill Prior To The Deadline. Cost: $ (make checks payable to SPAR) Non-Transferable Those that cancel before the registration deadline will pay a $25 cancellation fee. A Cancellation Form must be completed and turned in at SPAR. No phone cancellations. If a student fails the pre-test, they will receive a full refund Waiver I agree and indemnify and hold SPAR and its employees, instructors, and/or volunteers harmless from liability, loss, cost, or expense (including attorney fees, medical, and ambulance costs) that may occur to those listed above while participating in activities and/or programs at SPAR. I further understand SPAR does not provide insurance coverage for accidents and/or injuries that occur as a result of participation in, or use of its facilities. I acknowledge and accept the risks inherent in strenuous physical activity. I understand SPAR requests all participants to consult their physician before becoming physically active. All persons participating in SPAR sponsored activities and/or using SPAR properties/facilities agree to conduct themselves according to SPAR standards for behavior and abide by any and all disciplinary actions imposed by SPAR. Student s Signature Parent/Legal Guardian s Signature (if under 18 years old) Date / / U:\ARC\2017 Lifeguarding Registration.doc

2 American Red Cross Lifeguarding / 2017 March Weekend Class March 18, 19, 25, and 26 Saturday, 18th 8:00 am-5:00 pm, Being A Lifeguard, Rescue Skills Sunday, 19th 1:00-5:00 pm Pathogens, First Aid, CPR & Breathing Emergencies Saturday, 25th 8:00 am-5:00 pm Head, Neck, and Back Injuries & Review Sunday, 26th 1:00-5:00 pm Written Test & Final Skill Scenario Registration Deadline: 7:30 pm, Tuesday, March 14. Minimum Age 15 years old by March 26 Saturday, March 8 am. Students must (a) complete a 300 yard continuous swim using the Cancellations must be made in person, and in writing, at SPAR Recreation & Aquatic Center by Tuesday, March 18 in order to receive a full refund, less a $25.00 cancellation fee. Cancellations after March 18 are not eligible for a refund nor are the fees transferable to future programs/classes. Refund checks will be mailed within 5-7 business days. Late U:\ARC\2017 Lifeguarding Flyer March Weekends.docx 1000.MW17

3 American Red Cross Lifeguarding / 2017 April Weekend Class April 1, 2, 8, and 9 Saturday, 1st 8:00 am-5:00 pm, Being A Lifeguard, Rescue Skills Sunday, 2nd 1:00-5:00 pm Pathogens, First Aid, CPR & Breathing Emergencies Saturday, 8th 8:00 am-5:00 pm Head, Neck, and Back Injuries & Review Sunday, 9th 1:00-5:00 pm Written Test & Final Skill Scenario Registration Deadline: 7:30 pm, Tuesday, March 28. Minimum Age 15 years old by April 9 Saturday, April 8 am. Students must (a) complete a 300 yard continuous swim using the Cancellations must be made in person, and in writing, at SPAR Recreation & Aquatic Center by Tuesday, March 28 in order to receive a full refund, less a $25.00 cancellation fee. Cancellations after March 28 are not eligible for a refund nor are the fees transferable to future programs/classes. Refund checks will be mailed within 5-7 business days. Late U:\ARC\2017 Lifeguarding Flyer April Weekends.docx 1000.AW17

4 American Red Cross Lifeguarding / 2017 Spring Break I April 15, 17, 18, and 19 Saturday, 15th 8:00 am-2:00 pm, Being A Lifeguard, Rescue Skills Monday, 17th 8:00 am-4:00 pm Pathogens, First Aid, CPR & Breathing Emergencies Tuesday, 18th 8:00 am-4:00 pm Head, Neck, and Back Injuries & Review Wednesday, 19th 8:00 am-4:00 pm Written Test & Final Skill Scenario Registration Deadline: 7:30 pm, Tuesday, April 11. Minimum Age 15 years old by April 19 Saturday, April 8 am. Students must (a) complete a 300 yard continuous swim using the Cancellations must be made in person, and in writing, at SPAR Recreation & Aquatic Center by Tuesday, April 15 in order to receive a full refund, less a $25.00 cancellation fee. Cancellations after April 15 are not eligible for a refund nor are the fees transferable to future programs/classes. Refund checks will be mailed within 5-7 business days. Late U:\ARC\2017 Lifeguarding Flyer Spring Break I.docx 1000.SBI17

5 American Red Cross Lifeguarding / 2017 Spring Break II April 20, 21, 22, and 23 Thursday, 20th 8:00 am-4:00 pm, Being A Lifeguard, Rescue Skills Friday, 21st 8:00 am-4:00 pm Pathogens, First Aid, CPR & Breathing Emergencies Saturday, 22nd 8:00 am-2:00 pm Head, Neck, and Back Injuries & Review Sunday, 23rd 1:00-5:00 pm Written Test & Final Skill Scenario Registration Deadline: 7:30 pm, Monday, April 17. Minimum Age 15 years old by April 23 Thursday, April 8 am. Students must (a) complete a 300 yard continuous swim using the Cancellations must be made in person, and in writing, at SPAR Recreation & Aquatic Center by Tuesday, April 17 in order to receive a full refund, less a $25.00 cancellation fee. Cancellations after April 17 are not eligible for a refund nor are the fees transferable to future programs/classes. Refund checks will be mailed within 5-7 business days. Late U:\ARC\2017 Lifeguarding Flyer Spring Break II.docx 1000.SBII17

6 2017 American Red Cross Lifeguarding Review Course Tuesday, April 18 [ ] Saturday, May 13 [ ] Legal Name Mailing Address City State Zip Best Phone Alternate Phone Text [ ] Yes [ ] No Age Date of Birth / / The Review Course is open only to those currently certified in Lifeguarding Students must successfully complete the Lifeguarding to pass the Review. The Participant s Manual will be available for use during the Review. You may download the manual (free) at or you may purchase the manual at Cost: $75.00 (make checks payable to SPAR) Non-Transferable Discounts are available to members of the SPAR Aquatic Staff Those that cancel before the day of the class will pay a $25 cancellation fee; and, a Cancellation Form must be completed and turned in at SPAR. No phone cancellations. There will be no refund for cancellations after the class has begun. Waiver I agree and indemnify and hold SPAR and its employees, instructors, and/or volunteers harmless from liability, loss, cost, or expense (including attorney fees, medical, and ambulance costs) that may occur to those listed above while participating in activities and/or programs at SPAR. I further understand SPAR does not provide insurance coverage for accidents and/or injuries that occur as a result of participation in, or use of its facilities. I acknowledge and accept the risks inherent in strenuous physical activity. I understand SPAR requests all participants to consult their physician before becoming physically active. All persons participating in SPAR sponsored activities and/or using SPAR properties/facilities agree to conduct themselves according to SPAR standards for behavior and abide by any and all disciplinary actions imposed by SPAR. Student s Signature Date / / Parent/Legal Guardian (if under 18 years old) Do Not Write Below This Line Office Use Only [ ] Active SPAR Staff * $75.00 $ (Discount) = $ * Check The List Provided By the Aquatic Supervisor To Determine Status 2017 LGT Review Registration 1000.R417 & 1000.R517

7 2017 American Red Cross Lifeguarding Review Courses (includes CPR/AED/First Aid) Tuesday, April 18, OR Saturday, May 13 8:00 AM-4:00 PM SPAR Recreation & Aquatic Center 933 W. Parish Road, Sulphur, LA / The cost is $75, except that discounts are available for those that are, or have been, employed by SPAR. Not a SPAR employee? The course fee will be reimbursed for those that are hired by SPAR, work at least 240 hours, AND remain active through the end of the The Review Course is open only to those currently certified in Lifeguarding. 8:00 AM Registration and Roll Call 8:30 AM CPR/AED/First Aid 11:30 AM Lunch 12:00 PM Students must (a) complete a 300 yard continuous swim using the front crawl and/or breaststroke; (b) tread water for two minutes using only the legs; and (c) complete the following sequence in less than 1 minute, 40 seconds: 20 yard approach, surface dive to 10, retrieve a 10 lb. brick from the bottom, return 20 yards on the back holding the brick with both hands, and then exit the pool without the use of a ladder. 12:30 PM Lifeguarding Responsibilities and Rescue Skills 3:30 PM Written Test (students must score at least 80% to pass) The Participant s Manual will be available for use during the Review, or you may download the manual (free) at or you may purchase the manual at The certification period is two (2) years for Lifeguarding (CPR/AED/FA) LG Review Coure Flyer 1000.R417 & 1000.R517

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