2021 New Student Registration

Welcome, and thank you for making water safety a priority for your child(ren)! 
 
Please complete the following New Student Registration form. The more flexible you are with your time availability and location, the sooner you will be added to the schedule. Because our swim schedule is performance-based your child will receive a target month/date to start. If it is not possible to place you at your requested time/location, you will be offered an alternative. If you choose not to accept the alternate, your child will be placed in the queue and you will be notified as soon as an opening becomes available. Sometimes there are cancellations and early completions which will move everyone sooner in the queue.  
 
If you have additional questions, concerns, or would like to discuss lessons in further detail, please call or email. 407-252-7159  tina@littleotterswimacademy.com
 
The following form will take approximately 10 minutes to complete.  If there is a chance you might get interrupted along the way, please consider the "save and return" option.  It will time out if left open. There are many required fields. Please don't leave any of these fields blank, as the submission will be returned. At the end of the form, you will be redirected to Paypal for payment.  Your registration will be complete when your payment is processed.  You will receive a confirmation email with further instructions on what's next!
 
Thank you for trusting me to teach your child(ren) to swim and be safer in and around the water. 

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Participant Information

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Parent/Guardian Contact Information

Relationship to Participant: *
 
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Secondary Contact Information: If someone other than the person above will be attending lessons with the child, please provide their information here. 
Relationship to Participant:
 
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Health Information

1.Has this child ever been referred to or seen a specialist of any kind? If YES is selected, please give details below. *

Aquatic Information

3. Has this child ever been placed in a floating raft/tube, or used water wings, sometimes referred to as armbands, puddle jumper, or floaties? *

Scheduling Information

1. Where would you like lessons to take place? The more flexible you are with the location the sooner I will be able to accommodate you. You may check multiple boxes! * 🛈
 
2. If you indicated above that you would like lessons to take place at your home pool please indicate how your pool is heated
 
3. Preferred Lesson time (check as many boxes as possible):
The time MUST be the same every day, Monday-Thursday.  
**Please keep in mind the more flexible you are with times the faster you will get on the schedule! * 🛈
 
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5.What is your PREFERED start month? Please keep in mind that late afternoon and evening lessons are only offered through the end of May. The last round of students will be accepted in late August and run through the first week of October. Late October and November are reserved for refresher lessons (previously skilled students).
6. How did you find Tina Baron/ Little Otters Swim Academy? *
 

Participation Agreement

to participate in aquatic activity. My child is in good health and physical condition, and is not suffering from any conition that would prevent him/her from engaging in this activity.  
 
Please read carefully and be aware that in registering your minor child for participation in this program, you will be waiving and releasing all claims for injuries you or your child might sustain as a result of participation in any class or activity conducted by Little Otters Swim Academy, Tina Baron, Independent Swim Instructor. As a parent/guardian of a participant in Little Otters Swim Academy/Tina Baron's swim lessons, I recognize and acknowledge that there are certain risks associated. I agree to assume full responsibility of any injuries, property damage, or loss, which I, or my minor child, may sustain as a result of participating in any and all activities connected with or associated with these lessons. I agree to indemnify and hold Little Otters Swim Academy, Tina Baron harmless from any liability resulting from the use of premises and waive and relinquish all claims against Little Otters Swim Academy, Tina Baron and the pool owners that I or my minor child may sustain as a result of participating in any swimming program offered by Little Otters Swim Academy, Tina Baron. I have ready and fully understand the above waiver and release of all claims, and it shall not be modified orally.

 
Signature of Parent/Legal Guardian * 🛈
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Photo/Videography

Photographs and video (many of which are underwater) may be taken in conjunction with lessons by your Instructor. Video use is for training and review to improve your child's lessons.  I (parent/guardian) understand and agree that this media may be used for informational and advertising purposes.  Whenever possible those photos and videos will be shared with parents.
 
I (parent/guardian) agree that I will not post personal videos or photos on any social media site without the permission of Tina Baron, Little Otters Swim Academy. 
I (Parent/Legal Guardian) agree to these photo/video terms *
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Financial Agreement

Registration Fee
 
There is a one-time Registration Fee of $50 per student/$100 max per family, due at the completion of this form. 
 
Weekly fees

*If you are traveling to me at one of my provided "host pools" your weekly tuition fee is $85. Siblings are $75 per week. 
 
*If you are hosting additional children (other than your own) at your home pool, discounts will apply and your registration fee will be waived.
 
*If I travel to your home for private lessons for your children, there will be an additional $50 weekly trip charge. If you are more than 5 miles from downtown Oviedo or outside of my current travel area, an additional mileage charge will be applied based on the number of miles.
 
*Maintenance/Stroke/Snorkel lessons will be booked in a series of 2 per week (minimum). These lessons are scheduled in the same manner as your original series. Weekly fees will be based on where these lessons are to take place.

Weekly fees are due on MONDAYS 
 
When paying poolside: You may pay with a check (payable to Tina Baron) or cash.  Please place your payment inside an envelope (provided) with your child's first name and last initial on the outside with the date.  Place this envelope inside my binder in the clear zipper case labeled "payment". 
Returned check fee is $40.
 
Automated payments are also accepted. Due on Mondays. 
Pay pal:  baron_tina@yahoo.com (friends and family)
Venmo: @Tina-Baron-2
Parent/Legal Guardian Signature agreeing to financial terms * 🛈
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Almost Finished ...

Thank you for taking the time to complete the New Student Registration.  Please complete your form by paying your registration fee below.  
 
The next steps are:
 
1. After this form submission you will get a confirmation email with a link for your Lesson Guidelines.  Please download, print it if possible, and begin reading. This will better prepare you for what to expect with these lessons. 
 
2. Order your swim diaper and warm belly wet suit (if needed). All children aged 3 and under must wear a nondisposable swim diaper that does not have snaps or velcro.  Please see the previous page for ordering information
 
You will be contacted with a target schedule date and time.  In the weeks before your child's lessons are to start you will receive a confirmation of this.  If you need clarification or would like to discuss this further, please call or email.  
 
Thank you and I look forward to meeting you and teaching your child to be safer in and around the water!

Registration Payment

Please complete the registration by paying a one-time registration fee. After selecting the "continue" button below you will be redirected to PayPal.
 
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Please hit the "Continue" button below for your form to be complete! Thanks.