A signed permission form is required to complete your registration for Swim Lessons. If you completed the registration process online, you do not need to fill out the permission form below. If registering by mail or fax, please print the following section and submit with your registration to:

By Mail: Office of Continuing Education
UW-Platteville
1 University Plaza
Platteville, WI 53818
By Fax: 608-342-1454
Permission Form for Youth Participants (Signed permission forms are required for participation in UW-Platteville's programs.)

I hereby give permission for my child to participate and be photographed in youth classes, labs and field trips under staff supervision. I understand that some photos might be used for promotional materials.

Yes
No

I agree to hold harmless the Board of Regents at the University of Wisconsin System and their employees from any and all liability, injury, and loss arising out of or occurring in the course of my child's participation in this program. I certify that my child is fit to participate in all activities. In case of emergency, I grant permission for my child to be given treatment at a local hospital.

Child's Name: _________________________________

Children's Swim Level: ____________________

Signature of Parent/Guardian_____________________________
Date ________________