IT S TIME TO REGISTER FOR JUNIOR LIFEGUARDS!

111 S. Sierra Avenue Web: ci.solana-beach.ca.us E-mail: jrguard@cosb.org Phone: (858) 720-4445 IT S TIME TO REGISTER FOR JUNIOR LIFEGUARDS! Games, surfing, field trips, competitions, parents day, cookie day, team photos, banquets, DVDs fun in the sun on the beach with our friends! What could be better? WHAT S NEW THIS YEAR: o CREDIT CARDS! We now except Mastercard or Visa for tuition and uniform payment. Credit card payment can be made at the Lifeguard Headquarters or the Junior Guard Office, both located at Fletcher Cove, 111 S. Sierra Ave. o TWICE AS MANY SESSIONS FOR 7&8 YEAR OLDS We ve added sessions, including first session mornings, so check the calendar on the Information Sheet. o NEW NAME FOR THE 7&8 YEAR OLDS; THE GROMS We admit it, it was confusing calling the older kids Junior Guards and the younger kids Junior Juniors. Don t wait until the last minute to register if you need a specific session. Session 1A fills up very quickly, so register early if this is your preference. The Groms (7 & 8 years olds) have no swim test. First time participants ages 9-16, and all those kids moving up from the 7 & 8 year old groups to the 9 year old groups need to take a swim test. Swim test information is on the back of this page. We try to provide the highest quality program during all our sessions, but we put our resources into providing several special events during the four-week sessions that we do not provide during the two-week sessions. If these features are important to you, perhaps you should consider one of the longer sessions. All the information regarding this summer s programs is on the forms included in this package. You can also download additional forms on the city s website: ci.solana-beach.ca.us/ Feel free to contact me by e-mail or phone at any time. I look forward to seeing you on the beach this summer. Sincerely, Bill Feeney, Director

111 S. Sierra Avenue Web: ci.solana-beach.ca.us E-mail: jrguard@cosb.org Phone: (858) 720-4445 SWIM TEST INFORMATION For first-time participants 9 16 years old The Groms (7 & 8 years olds) have no swim test. 100 yard swim For time 5 yards underwater Pass / Fail 3 min. treading water Pass / Fail 100 yard swim qualifying times Ages 9-11 under 2:45 min Ages 12-13 under 2:30 min Ages 14-16 under 2:15 min When: Sunday, May 20 th or Sunday, June 10 th, Noon - 2:00 PM Where: San Dieguito Boys & Girls Club 533 Lomas Santa Fe Drive, Solana Beach. Cost: A fee of $2 per swimmer will be charged. (the money goes directly to the Boys & Girls Club for the use of their pool) ENROLLMENT PACKET CHECKLIST Completed Enrollment Form Waiver / Consent Form (both sides) Check made out to: City of Solana Beach* Completed Uniform Order Form (if any uniform items were ordered) *Payments of cash or credit cards can be made in person Mail to or Drop off at Lifeguard Headquarters: 111 S. Sierra Avenue New participants in the program, 9 or older, plan to complete a swim test

SBJG INFORMATION SHEET JUNIOR GUARDS Ages: 9 16 years old SESSIONS, DATES AND TIMES Session 1A 4 Weeks Morning Monday June 18 th - Friday July 13 th 8:00-11:30 AM Session 1P 4 Weeks Afternoon Monday June 18 th - Friday July 13 th 12:00-3:30 PM Session 2A 4 Weeks Morning Monday July 16 th - Friday Aug 10 th 8:00-11:30 AM Session 2P 4 Weeks Afternoon Monday July 16 th - Friday Aug 10 th 12:00-3:30 PM Session 3A 2 Weeks Morning Monday Aug 13 th - Friday Aug 24 th 8:00-11:30 AM Session 3P 2 Weeks Afternoon Monday Aug 13 th - Friday Aug 24 th 12:00-3:30 PM TUITION Sessions 1A, 1P, 2A, 2P 4 Weeks $325 for City of Solana Beach residents $375 for non-residents Sessions 3A & 3P 2 Weeks $225 for City of Solana Beach residents $250 for non-residents GROMS (formerly known as Juniors ) Ages: 7 & 8 (no swim test required) SESSIONS, DATES AND TIMES Grom 1 2 Weeks Morning Monday June 18 th - Friday June 29 th 8:00-11:30 AM Grom 2 2 Weeks Afternoon Monday June 18 th - Friday June 29 th 12:00-3:30 PM Grom 3 2 Weeks Morning Monday July 2 nd - Friday July 13 th 8:00-11:30 AM Grom 4 2 Weeks Afternoon Monday July 2 nd - Friday July 13 th 12:00-3:30 PM Grom 5 2 Weeks Morning Monday July 16 th - Friday July 27 th 8:00-11:30 AM Grom 6 2 Weeks Afternoon Monday July 16 th - Friday July 27 th 12:00-3:30 PM Grom 7 2 Weeks Morning Monday July 30 th - Friday Aug 10 th 8:00-11:30 AM Grom 8 2 Weeks Afternoon Monday July 30 th - Friday Aug 10 th 12:00-3:30 PM Grom 9 2 Weeks Morning Monday Aug 13 th - Friday Aug 24 th 8:00-11:30 AM Grom 10 2 Weeks Afternoon Monday Aug 13 th - Friday Aug 24 th 12:00-3:30 PM TUITION: $250 per session (discounts for additional sessions) DISCOUNTS Additional child in a session discount Additional session attended discount $25 per additional child $25 per additional session 1. Calculate your family s total tuition cost for all children in all sessions, and enter that number on line 1. TUITION of the enrollment form. 2. Then on the chart below, cross reference the number of children by the number of sessions they are attending, and enter that number on line 2. DISCOUNT of the enrollment form. TUITION DISCOUNT CHART 1 session 2 sessions 3 sessions 4 sessions 5 sessions 1 child 0 -$25 -$50 -$75 -$100 2 children -$25 -$100 -$175 -$250 -$325 3 children -$50 -$175 -$300 -$425 -$550 4 children -$75 -$250 -$425 -$600 -$775 5 children -$100 -$325 -$550 -$775 -$1000

FOR OFFICE USE ONLY Amount $ Receipt # Check # Date Last Name, SOLANA BEACH JUNIOR LIFEGUARDS ENROLLMENT FORM First Name SESSIONS circle choice(s) Junior Guards (9-16 year olds) 1A 1P 2A 2P 3A 3P Groms (7 & 8 year olds) 1 2 3 4 5 6 7 8 9 10 Is this participant a returning Junior Lifeguard? Yes No If not, a swim test is required for 9-16 year olds. There is no swim test for 7 & 8 year olds (Juniors) T-shirt size - circle one Junior sizes S M L Adult sizes S M L XL Sex: M F Date of Birth: Age first day of session: Health Concerns? Yes No If Yes, please describe on back of Waiver/Consent Form Will this Junior Lifeguard need any accommodation from the staff or program? Please explain: If contact information appears on sibling s form, write their name here and skip this section: Mother s Name: Father s Name: Home: Home: Phone Work: Phone Work: Cell: Cell: Address: City: State: Zip: Mailing Address (if different): See INFROMATION SHEET and the UNIFORM ORDER FORM for information about filling out this section. Please note that purchasing additional uniform items is optional. If payment appears on sibling s form, write their name here and skip lines 1-5 Total amount of tuition (can be family total) 1. TUITION Total amount of discount (if any) 2. DISCOUNT Subtract line 2 from line 1 and enter here 3. SUB-TOTAL Total amount of uniform purchase (optional) 4. UNIFORM TOTAL Sum of line 3 and line 4 5. TOTAL Make checks payable to: City of Solana Beach We accept cash, check, Visa or MasterCard. Credit transactions must be done in person. Mail or drop off completed forms to: 111 S. Sierra Ave There is a $50 processing fee for any tuition refunds and a $35 processing fee for returned checks

WAIVER/CONSENT FORM Release from Liability, Authorization to Consent to Treatment of Minor and Consent to Use Images of Minor for Publicity Purposes In consideration of the acceptance of the application of the above named Junior Lifeguard(s), the participating minor(s) for participation in the Solana Beach Junior Lifeguard Program, and with complete understanding that he/she shall take a physical test of swimming skills and also will engage in various physical activities on the beaches and waters of the Pacific Ocean at a designated time and place, I, intending to be legally bound, do hereby, for myself, my heirs executors, and administrators, waive, release and forever discharge any and all rights and claims for injury, deaths or damages which may hereafter accrue to me/my child against the Solana Beach Marine Safety Department, the City of Solana Beach, and/or their respective officers, employees, agents or volunteers which may be suffered by him/her or me in connection with or participation in and said Junior Lifeguard Program except for injuries, damage, or death resulting solely from the gross negligence or willful misconduct of the City, its officers, or employees in the operation or supervision of the program. I further agree that neither I/my child, nor any assignees, heirs, guardians, conservators or legal representatives will make any claim against, or sue, the Solana Beach Marine Safety Department and/or the City of Solana Beach and/or their respective officers, employees, agents or volunteers for such personal injury, death or property damage related to the foregoing and any subsequent medical treatment or care, as further discussed below. I understand that by participation in the Junior Lifeguard Program the participating minor(s) will engage in various dangerous or potentially dangerous activities including, but not limited to, ocean swimming, diving, wading, beach running, surfing, body surfing, body boarding, boating, ultimate Frisbee, throwing and catching balls, or other similar activities including being in close proximity to City s eroding coastal bluffs. I hereby certify that no physician, surgeon, or other licensed health care practitioner has advised me, after due inquiry that the participating minor(s) should not participate in any Junior Lifeguard activity. I have discussed the risks of such participation with the participating minor(s), and being fully informed hereby assume all risks of injury or death relating to the participation by the participating minor(s) in the foregoing activities. Initial here and then complete page 2 of WAIVER/CONSENT FORM

PAGE 2 - WAIVER/CONSENT FORM I (We), the undersigned, parent(s) of the participating minor(s), do hereby authorize all representatives of the Solana Beach Marine Safety Department and the City of Solana Beach as agent(s) for the undersigned to consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the provision of the Medical Practice Act on the medical staff at any accredited hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital being required but is given to provide authority and power on the part of our aforesaid agent(s) to give specific consent to any and all such diagnosis, treatment or hospital care which the aforementioned physician in the exercise or his judgment may deem advisable. It is understood that effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that none of the above treatment will be withheld if the undersigned cannot be reached. This authorization is given pursuant to the provisions of section 6910 of the Family Code of California and any other applicable law. This authorization shall remain effective until revoked in writing delivered to said agent(s), in compliance with Consent Manual, California Hospital Association. I (We), the undersigned, parent(s) of the participating minor(s), do hereby consent for the City of Solana Beach to photograph the participating minor(s) and further consent for the City of Solana Beach and its assigns or successors, to use of images of the minor in publication(s)/media and whatever ways they may desire, including audiovisual productions, television and electronic transmission for the purpose of publicizing activities of the City of Solana Beach; furthermore, I (we) hereby consent that such photographs and plates from which they are made shall be the property of the Photographer, and the City of Solana Beach shall have the right to duplicate, reproduce and make other uses of such photographs and plates for publicity and publications as they may desire free and clear of any claim whatsoever on my part. The Photographer will not sell the photos without permission of the City of Solana Beach. I (We) have the right to contract for the participating minor(s), and freely sign this release, which I (we) have read and understood. Signature of parent or legal guardian Signature of parent or legal guardian / / Date / / Date Emergency Contact Phone Doctor Phone Health Concerns For the Safety and well-being of your child, please list all conditions that the program should be aware of regarding your child s health. All information provided is confidential, for Solana Beach Junior Lifeguard use only, and is protected by law.

FOR OFFICIAL USE ONLY Amount $ Receipt # Check # Date SOLANA BEACH JUNIOR LIFEGUARDS UNIFORM ORDER FORM Last Name First Name Session Uniforms are a requirement of the program and must be worn at all times. Uniforms consist of a Junior Lifeguard t-shirt and red board shorts or swim trunks. Girls are required to wear a red, one or two-piece, bathing suit that is appropriate in appearance. We will provide everyone with one t-shirt at no cost on the first day. All other uniform items may be purchased with the use of this form, or you may purchase them elsewhere as long as they are solid red and appropriate. UNIFORM ITEMS FOR PURCHASE (OPTIONAL) Price Extra Junior Guard T-shirts Junior S M L Adult S M L XL $10 Rash-guard (white with logo) Junior S M L Adult S M L XL $20 Sweatshirt - Hooded (navy w/logo) Junior S M L Adult S M L XL $25 Sweatshirt - Hood/Zip (navy w/logo) Junior S M L Adult S M L XL $25 Boys Quiksilver boardshorts 7 7X 22 23 24 25 26 27 28 29 30 31 32 33 34 $25 Girls red boardshorts Children 4 6 8 10 12 14 Junior 1 3 5 7 9 $25 Girls one-piece suits Children 4 6 XXS(8-10) XS(12-14) Junior S(1-3) M(5-7) $32 Girls two-piece suits Children 6 XXS(8-10) XS(12-14) Junior S(1-3) M(5-7) L(9-11) $32 TOTAL You can pay for uniform items with this form by itself or you can add the amount from this form to line 4 on your Enrollment Form. Make checks payable to: City of Solana Beach Mail or drop off this form by itself, or as part of your completed Enrollment Packet to: 111 S. Sierra Ave