Withdrawal Form

To exit your monthly swim class, please submit this online form at least 15 days prior to your swimmer’s last month of lessons. For example, if you wish for August to be your last month of lessons, your completed withdrawal notice must be received by GSS by the 15th of August.

If you are having a scheduling conflict, we would be happy to help you switch to another day and time or address any other issues you may be having.

For their safety and your peace of mind, all children need to be able to swim a strong freestyle stroke with good breathing. Most experts agree that the goal of 300 yards of freestyle is a good measure of water safety. And even for children who can swim, please be a designated Water Watcher when any children in your care are in or around the water. Their safety depends on your constant parental vigilance!

Parent Information

First Name *
Last Name *
Email *

Phone

Area Code
Phone Number

Cell Phone

Area Code
Phone Number

Swimmer's Information

Swimmer's Name *
Lesson Day / Time *

Reason For Withdrawal

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MovingMedicalSchedule ConflictOther
If Other, please enter details:
Comments

Last Month my swimmer will attend

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Notice

Notice *
I understand that my registration will be cancelled when Guardian Swim School receives this completed withdrawal form. Withdrawal forms must be received 15 days prior to my child's final month end lesson. I understand space may only be available in a class other than the class I am withdrawing from. I also understand that I will be billed for the next billing cycle if this notice is not received before the 15th of my child's final month of lessons, as per the registration agreement. Drops put in after the Autopay run will be effective on the last day of the month that has been paid for.

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Drowning Statistics: Drowning remains the leading cause of death in the U.S. for children ages 5 and under and the 2nd leading cause of death for children ages 14 and under (American Institute for Preventative Medicine). A child can drown in the time it takes to answer the phone. (U.S. Consumer Product Safety Commission)

Of all preschoolers who drown, 70% are in the care of one or both parents at the time of the drowning and 75% are missing from sight for 5 minutes or less. (National Center for Injury Prevention and Control)