Learn to Swim Registration Form
Participants Must Abide by ALL Pool Rules and Regulations
Register, then…
LCC will Send You a Voucher
Here are Five Easy Ways to Register:
Participating Facilities
Parkwood YMCA
2306 Haslett Rd East Lansing, MI 48823
(517) 827-9680
http://www.ymcaoflansing.org/parkwood/
Hunter Park
1400 E Kalamazoo St Lansing, MI 48912
(517) 483-6686
http://www.lansingmi.gov/parks
SSCC Hill Pool
5825 Wise Rd Lansing, MI 48911
(517)483-6686
http://www.lansingmi.gov/parks
Waverly East Intermediate School
3131 W Michigan Ave Lansing, MI 48917
(517) 484-5600
http://www.deltami.gov/index.php/parks-recreation/aquatics-program/
Westside Community YMCA
3700 Old Lansing Rd Lansing, MI 48917
(517) 827-9670
http://www.ymcaoflansing.org/westside/
Oak Park YMCA
900 Long Blvd Lansing, MI 48911
(517)827-9700
http://www.ymcaoflansing.org/oakpark/
FAX –
Fill out this Registration form and fax to:
(517) 483-9805
Fill out this Registration form and mail to:
Lansing Community College
6000W – CEWD West Campus
Building
5708 Cornerstone Dr
Lansing,
MI 48917
PHONE –
Fill out this form and call: (517) 483-1415
IN PERSON –
Drop off the completed Registration form at:
Commu
nity Education & Workforce Development
West
Campus
Building - M105
5708 Cornerstone Dr
Lansing,
MI 48917
Email –
Fill out this form and email it to:
LCC_CCE@star.lcc.edu
“By accepting this voucher, I hereby waive all
claims or causes of action against LCC, its
Trustees, its officers, directors, employees,
students and agents of each of them, arising
out of my participation in the activity and
hereby release, hold harmless, and discharge
them from all liability in connection
therewith.”
Child’s Last Name: Child’s First Name:
Male Female
Age:
School District:
Low Income Household
Yes
No
(as determined by FREE or reduced lunch eligibility guidelines)
Parent / Guardian Name:
Address:
Apt. #
City: State:
Zip:
Home Phone:
(
)
Alternate Phone:
(
)
Parent’s Email Address:
Preferred Method of Distribution:
Email Mail
(Please keep in mind US Postage
Mail will take longer to arrive.)
Date Received: _______________
Entered
Staff Initials:_________
