001-073-30620
City of Seal Beach Swim Passes
211 8
th
Street, Seal Beach, CA 90740
Office (562) 431-2527 ext. 1344 Fax (562) 430-8763
Participants Name: ___________________________________________________________
Address____________________City_______________________Zip___________________
Home Phone_______________________ Mobile Phone______________________________
Email:
16 Swims ($80) ___ 34 Swims ($136) ___ Youth-16 swim ($40) ___ Annual ($300) ___
Recreation Swim Summer Pass
Seal Beach Resident ($30) _____ Non-Resident ($60) _____
RELEASE AND INDEMNIFICATION
I hereby agree to indemnify, defend and hold harmless the City of Seal Beach, its officers, employees, agents and volunteers
from and against any and all claims, damages, liability, bodily injury, death, expenses, and judgments, including attorney fees,
expert witness fees and court costs in any way arising from my (or my child’s) participation in the program for which I am
registering him/her. I understand and am familiar with the nature of the event or activity and recognize that this event or activity
can be dangerous to me (or my child) and accept those dangers. In case of emergency, I give my permission for emergency
medical treatment. I also give my permission to the City of Seal Beach to photograph me or my child participating in this event or
activity for advertising purposes for the City of Seal Beach and acknowledge I will not receive any compensation for such use. My
signature acknowledges that I understand and agree to the above conditions.
DATED: __________________ SIGNATURE: _____________________________________
1. Do not enter pool if the lifeguard is not present.
2. Lap swimmers must abide by the posted rules and lifeguard direction.
3. During Adult Lap Swim, parents may not take their children in pool.
4. The Lifeguard is not allowed to watch your children or personal property.
5. No deck changes; use the changing rooms or restrooms.
6. Circle pattern is required if all lanes already have two swimmers. Lifeguards may ask you to change lanes
to better accommodate swimmers being grouped according to speed
7. No Diving.
8. The Pool Office is restricted to City of Seal Beach employees only.
9. Swimmers must have current pass present each day to swim
10. No foul Language; remember the pool is located on an elementary school campus.
11. The City of Seal Beach reserves the right to revoke lap swim passes for noncompliance of pool rules or
Lifeguard direction.
12. $10 FOR LOST PASS REPLACEMENT
I have read and agree to the above rules governing the City of Seal Beach Recreation Swim.
DATED: _________________ SIGNATURE: ______________________________________
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