Registration Form – Molly Jarvis

You are registering for Swim Safe Now Lessons with Certified Instructor, Molly Jarvis. A tentative start date and lesson time should have already been confirmed with your Instructor. Start dates are subject to delays due to weather, illnesses and other factors.

*If this is not the correct Instructor or availability has not been confirmed, please do not continue as the Registration Fee is Non-Refundable.

New Student Registration Fee is $75 Returning Student Registration Fee is $35 Medical Updates for Current Students are Free

Lesson Fees are paid directly to your Instructor and are not included in the Registration Fee.

Swim Safe Now Lessons are held 4 days per week, typically Monday - Thursday, for approximately 15 minutes per lesson.

In consideration of being allowed to voluntarily participate in any activities and/or programs taking place on the premises of Molly Jarvis’ home or host pools, or otherwise associated with Swim Safe Now LLC, its owners and operators, the undersigned Parent or Guardian (hereinafter “Undersigned” and “I” interchangeably), on behalf of the minor participant(s) (herinafter “child(ren)” and “particant(s)” interchangeably) named below, hereby acknowledges, appreciates and agrees to the following: I represent that I am the parent or legal guardian of the minor participant named below and on this registration. As the legal parent or guardian, I for myself, the minor participant(s), any heirs, estate, successors and assigns release Molly Jarvis, heirs and assigns, Swim Safe Now, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, slip, fall and/or negligent instruction or supervision, including death, that may be sustained by the participant and/or the Undersigned, while in or upon the premises or any premises under the control and supervision of Molly Jarvis, Swim Safe Now LLC, its owners and operators or in route to or from any said premises. I, for myself, the minor participant(s) named below, any heirs, estate, successors and assigns, hereby acknowledge, accept and assume all the risks and hazards arising out of or related to the participation of any activities taking place on Molly Jarvis’ premises or otherwise associated with Swim Safe Now LLC, its owners and operators, resulting from the negligence of Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators.

This Waiver includes, but is not limited to, any claims against Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators for negligence or gross negligence of any kind or nature related to the design, layout, configuration, construction, maintenance, operation, supervision, instruction or advice, allowing another Instructor to participate in a classes, subcontractor hiring and retention and any other aspect of interaction or facility use by or between Undersigned and Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators.

Undersigned acknowledges that Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators shall not be liable to Undersigned for any claims, demands, injuries, damages or actions or causes of action whatsoever arising due to injury to Undersigned, Undersigned’s child(ren), Undersigned’s guests or property arising out of or in connection with the use by Undersigned and/or Undersigned’s child(ren) and/or Undersigned’s guests, of the services or facility of Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators or the premises where same is located and Undersigned hereby releases and holds Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators harmless from all claims which may be brought against them by Undersigned or on Undersigned’s behalf for any such injuries or claims aforesaid and completely and irrevocably releases and waives his/her rights to any claims as otherwise outlined within this paragraph.

PARENTAL/ADULT SUPERVISION REQUIRED AND ACKNOWLEDGED I acknowledge that Molly Jarvis’ home or host pool may contain items such as toys and animals in the assigned swimming/waiting area I hereby acknowledge the child(ren) must use the toys, observe the animals and use the items and any areas at his/her/their own risk; I agree to monitor and protect the child(ren) at all times and I, the minor participant(s) any heirs, estate, successors and assigns, further hereby indemnify and hold harmless Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, brought as a result of any alleged injury sustained by the named child(ren).

ASSUMPTION OF RISK

I understand, agree, and acknowledge that there are risks inherent in swimming activities conducted by Swim Safe Now LLC and Certified Instructor, Molly Jarvis, and that the minor participants could suffer an injury. With the full understanding of the facts, I state that to the best of my knowledge, the minor participants listed have no medical, physical, or emotional health conditions, which would hinder or prevent his/her/their participation in Swim Safe Now LLC programs. My child(ren) has been examined by a certified physician within the last year and is physically fit to participate in survival swim lessons. He or she is free from any contagious disease. If any child listed below develops or has manifest a previously unknown medical/physical or emotional health conditions during his/her/their participation in Swim Safe Now LLC Lessons, I, for myself, the minor participant(s) any heirs, estate, successors and assigns continue to hold harmless and indemnify and hold harmless Molly Jarvis, heirs and assigns, Swim Safe Now LLC, its owners and operators from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees, brought as a result of any alleged injury sustained by the named minor participants.

SEVERABILITY

I further agree and understand that this Waiver will extend to all claimed wrongful acts of the released parties to the greatest extent allowed under the laws of the State of Florida, including the negligence of any of the released parties. The Undersigned further expressly agrees that the foregoing Waiver is intended to be as broad and inclusive as is permitted by the laws of Florida and that if any portion thereof is held by a court of competent jurisdiction to be invalid, the Undersigned agrees that such provision will be deemed deleted from this Waiver without invalidating the remaining provisions of this Waiver or affecting the validity or enforceability of the remaining provisions.

I HAVE READ THESE RULES AND I ACCEPT AND AGREE TO FOLLOW THEM. I ALSO ACKNOWLEDGE THAT THIS IS MY BINDING CONTRACT THAT WILL BE VALID FOR THE ENTIRE DURATION OF LESSONS FOR AS MANY YEARS AS MY CHILD/CHILDREN IS/ARE IN LESSONS. IT IS UNDERSTOOD AND AGREED THAT THIS IS FULL AND FINAL RELEASE AND WAIVER OF ALL CLAIMS OF EVERY NATURE AND KIND WHATSOEVER IN CONSIDERATION OF BEING ALLOWED TO VOLUNTARILY PARTICIPATE IN ANY ACTIVITIES AND/OR PROGRAMS TAKING PLACE ON THE PREMISES OF MOLLY JARVIS’ HOME OR HOST POOL, IN THE CASE OF A GUEST, IN EXCHANGE FOR ENTRY ONTO THE PREMISES AND/OR INTO THE PROGRAM.

I UNDERSTAND, AGREE, AND ACKNOWLEDGE THAT THERE ARE RISKS INHERENT IN SWIMMING ACTIVITIES CONDUCTED BY MOLLY JARVIS. WITH THE FULL UNDERSTANDING OF THE FACTS, I STATE THAT TO THE BEST OF MY KNOWLEDGE, MY CHILD LISTED HAS NO MEDICAL, PHYSICAL, OR EMOTIONAL HEALTH CONDITIONS, WHICH WOULD HINDER OR PREVENT HIS/HER PARTICIPATION IN SWIM SAFE NOW PROGRAMS. MY CHILD HAS BEEN EXAMINED BY A CERTIFIED PHYSICIAN WITHIN THE LAST YEAR AND IS PHYSICALLY FIT TO PARTICIPATE IN SWIM LESSONS. HE OR SHE IS FREE FROM ANY CONTAGIOUS DISEASE.