I certify that I am the parent or legal guardian of my child(ren), or that I am the participant if over the age of 18. I hereby give my permission for any supervisor, coach, or staff member associated with Banks Aquatic Coaching to seek and authorize appropriate medical attention for myself/my child(ren) in the event of accident, injury, or illness.

I am aware of and accept the risks associated with participation in swimming and aquatic activities at Banks Aquatic Coaching, including but not limited to use of: the pool, pool deck, changing rooms, common areas, doors, equipment, diving blocks, steps, sidewalks, parking lot, and surrounding facilities. These risks may include, but are not limited to: slips, falls, ear and eye infections, colds, abrasions, cuts, nosebleeds, burns, stings, rashes, head injuries, injured or broken limbs, paralysis, drowning, and even death.

I understand that participation in swim lessons involves inherent risks, and I assume full responsibility for any and all injuries or damages that may occur. I agree to be solely responsible for any medical costs that may arise as a result of such injuries or damages.

I hereby waive, release, and forever discharge Banks Aquatic Coaching, its owner (Coach Jay Xavier Banks), instructors, staff, and the facility (Four Points by Sheraton Allentown Lehigh Valley) from all rights and claims for damages, injury, or loss to person or property that may be sustained or occur during participation in any Banks Aquatic Coaching activities, whether or not such damages or loss are due to negligence.

I further acknowledge that I/my child(ren) am/are physically fit and fully capable of participating in swimming lessons and related activities.