Aquatics Program-Autism/Learning Disability Winter 2024

The ASD children will be participating in a 30 or 45 minute swim program at TBAM. The program will focus on teaching the children important survival skills in the water, while also catering to their comfort level. The children will not be required to submerge underwater if they are scared, and instructors will work closely with each child to ensure they feel safe and confident in the pool. This program is designed specifically for children on the autism spectrum who are five years and older, and we look forward to seeing them develop their skills and confidence in the water. We understand that many children with autism have sensory issues (SID) anxious about the water. Through our program, our goal is to help your child develop a lifelong love for swimming while teaching them important skills for water safety.

Classes are Monday-Friday, new swimmers must schedule an interview before registering for classes.
You can choose a 30 or 45 minute 1 on 1 session with your child.
After your interview contact Claudia at swim@tbam.org to schedule your 1 on 1 lessons. Once you have scheduled your lessons please proceed with registration.

Parent's First Name

Parent's Last Name

* First Name of Participant

* Last Name of Participant

* Participant's DOB

* Email

Home Phone

* Cell Phone

* Address

* City

* State

* Zip

* Name of School:

* Any medical problems?

Diagnosis:

Referred by?

Classes are Monday-Friday
Each class is a 30 or 45 minute 1 on 1 session with your child.
Contact Claudia at swim@tbam.org to schedule your 1 on 1 lessons.
Once you have scheduled your lessons please proceed with registration.

January Classes

February Classes

* Lessons in February 2024 (NO CLASSES on Monday, February 19)

Please Select OnePlease Choose 1February 2024- 4 30 Minute Classes per month $280February 2024- 8 30 Minute Classes per month $560February 2024- 4 45 Minute Classes per month $320February 2024- 8 45 Minute Classes per month $640N/AThese lessons must be scheduled with Claudia prior to registration

How many 30 minute Individual Classes in February at $70 per class

How many 45 minute Individual Classes in February at $80 per class

March Classes

* Lessons in March 2024

Please Select OnePlease Choose 1March 2024- 4 30 Minute Classes per month $280March 2024- 8 30 Minute Classes per month $560March 2024- 4 45 Minute Classes per month $320March 2024- 8 45 Minute Classes per month $640N/AThese lessons must be scheduled with Claudia prior to registration

How many 30 minute Individual Classes in March at $70 per class

How many 45 minute Individual Classes in March at $80 per class

April Classes

How many 30 minute Individual Classes in April at $70 per class

How many 45 minute Individual Classes in April at $80 per class

May Classes

How many 30 minute Individual Classes in May at $70 per class

How many 45 minute Individual Classes in May at $80 per class

Total Due

Maintain Consistency: The most important key to yours or your child's success is consistency. Regular attendance is essential. Whenever possible, take time to practice the skills we teach in class at home.

Communication: Communication is essential. If you have any concern or problem, please email Claudia immediately so we can give you the attention that you deserve. The participant's development is our top priority.

Cancelation: If you need to cancel for any reason, a 24-hour notice is required without charge. Should weather be a factor, you will be contacted at least 30 minutes prior to the start of class.

Swim Waiver

NOTICE: PLEASE READ THE FOLLOWING LANGUAGE CAREFULLY BEFORE SIGNING THIS AGREEMENT

WAIVER AND RELEASE OF LIABILITY Swimming Program

1. Assumption of Risk: I understand that swimming and/or using a pool involve certain inherent risks, including but not limited to, the risk of injury, illness, or even death. I acknowledge that I have been informed of these risks and voluntarily assume all risks associated with participating in the Swimming Program.

2. Health and Fitness: I certify that I am physically and mentally capable of participating in the Swimming Program. I have consulted with my healthcare provider and have received medical clearance to engage in swimming activities. I understand that it is my responsibility to inform the Swimming Program organizers of any changes in my health or fitness that may affect my ability to participate safely.

3. Release of Liability: I agree that TBAM, its directors, officers, employees, volunteers, and agents shall not be responsible for injury, death or property loss or damage which may directly or indirectly result from my participation in the Swimming Program or use of the pool for any reason, including negligence on the part of TBAM. I hereby expressly release, discharge, and hold harmless TBAM, its directors, officers, employees, volunteers, and agents from any and all claims, demands, causes of action, liabilities, costs, or expenses, including attorneys’ fees, arising out of or related to any injury, illness, or damage that may occur as a result of my participation in the Swimming Program and/or use of the pool, including the negligence of TBAM.

4. Indemnification: I agree to indemnify and hold harmless TBAM, its directors, officers, employees, volunteers, and agents from any and all claims, demands, causes of action, liabilities, costs, or expenses, including attorney fees, arising out of or related to my participation in the Swimming Program.

I hereby expressly agree that this Waiver and Release of Liability is intended to be as broad and inclusive as permitted by the laws of the State of Florida and that if any portion hereof is held invalid, the remainder of the Waiver and Release will continue in full force and effect. I further agree that the venue for any legal proceeding shall be Miami-Dade County, Florida.

5. Photographic Release: I grant TBAM, the right to take photographs or videos of me during the swimming program. I understand that these images may be used for promotional purposes, including but not limited to, brochures, websites, social media, and other marketing materials. 6. Emergency Medical Treatment: In the event of an emergency, I authorize TBAM and its representatives to seek and provide necessary medical treatment, including but not limited to, first aid, CPR, and calling emergency medical services. I have carefully read and fully understand the contents of this Waiver and Release of Liability. I am aware that by signing this document, I am waiving certain legal rights that I or my heirs, executors, administrators, and assigns may have against TBAM. I voluntarily sign this Waiver and Release of Liability, intending to be legally bound by its terms.

BY SIGNING BELOW, I hereby acknowledge that I am voluntarily participating in the swimming program, organized by Temple Beth Am (TBAM) and conducted by Movement Works (“Swimming Program”). In consideration of being allowed to participate in this program, I agree to the following terms and conditions.

* Full Name:

I hereby acknowledge that I am voluntarily participating in the swimming program, organized by Temple Beth Am (TBAM) and conducted by Movement Works (“Swimming Program”). In consideration of being allowed to participate in this program, I agree to the following terms and conditions.

Date:

BY SIGNING BELOW, I hereby acknowledge that payment is due in full prior to class. There are NO Credits or Refunds and I am responsible for calling ahead to cancel a swim class and to reschedule that class.

* Full Name:

Date: