Back to Basics Academy Inc.

Welcome to our On-Line Registration area...

Easy & convenient on-line registration, See you soon!

Please complete the registration form below. You will be contacted shortly before the scheduled
start date to confirm class date and time. Feel free to contact us by phone or e-mail if you have
any questions, concerns, or issues with registering.

Parent/Guardian Information:

Name of parent/guardian:
Address:
City:
Postal Code
Home Phone #:
Cell Phone # / Business Phone #:
Primary Email address :
Alternate Email address :

Participant Information:

	Participant #1	Participant #2	Participant #3
Given Name(s)
Family Name
Date of Birth
Gender

Please provide a brief description of each participants swimming history & ability in the space below. Information such as comfort level, programs attended, most recently learned skills or levels completed would be greatly appreciated.

Scheduling of Classes:

Please select the 'Session' you wish to register for, your preferred day, earliest start time and latest start time for lessons. We do require you provide a 2 hour time window within in which your lessons can be scheduled. We will make all attempts to meet your specific time requests and to have siblings/friends attend lessons at the same time.

Tuesday - 3:30pm to 8:30pm (Summer Session Only)	Thursday - 3:30pm to 8:30pm	Saturday (AM) - 8:15am to 12:45pm Saturday (PM) - 5:30pm - 8:00pm	Sunday - 8:00am to 1:00pm

'Session'

Day

Earliest Start

Latest Start

#1 Choice

#2 Choice

Optional client feedback information: (This area of the registration is optional, thank you for your time if you choose to complete it)

Are you a returning Back to Basics Client from a previous session? ( Thank you ! )
If you are a new client, were you referred by someone to our program?
If you were referred by someone, could you please tell us who so we can thank them?
How did you hear about our program?

** Refunds are provided in accordance with the Ontario Government Consumer Protection Act
** Due to the limited space and pool time we do not offer make up lessons for missed classes