Unsupervised Children�s Policy by WQ64Ogg


									                     CHSPA Unsupervised Children’s Policy
Children under the age of 12 may not be left unsupervised in the pool area. Children ages 12-16 may be
dropped off without supervision only if this “Unsupervised Children’s Waiver” has been signed and is on file at
the pool desk. You may drop this completed form at the pool desk during regular business hours.

           Unsupervised Children’s Disciplinary Contract
                     For Children Ages 12-16
I (parent/legal guardian)_____________________________, give my full permission that my
child(ren)                                      ,                                      ,
                                        ,                                      , and guest(s) that
accompany my child may attend the CHSPA swimming pool in my absence.
I also state on this release form that my child(ren) and their guest(s) are 12 years old on or before
___________ (today’s date). I understand that this is a release of liability, and that I am responsible
for my children’s behavior while at CHSPA. I, as the parent/guardian, do not hold CHSPA or the pool
management company responsible for any actions that are not conducive to the rules and regulations of
CHSPA. I confirm that my child(ren) and their guest(s) are capable of swimming in any area of the
Upon signing this agreement, I agree that my child will abide by all rules and regulations. In the
unforeseen circumstance that a disciplinary problem does occur, I agree to comply with the General
Manager’s decision to rectify the situation. I understand that multiple offenses can result in the
termination of this privilege and agreement. I agree to pick up the child(ren) immediately if there is a
problem, and I receive a phone call from the Pool management.

My immediate contact phone number(s): ___________________________________ (list cell phone 1st)

                       (A new form must be completed and signed each pool season.)

I have read the above statements and agree to comply.

Signature of Child                      Date            Signature of Child                       Date

Signature of Child                      Date            Signature of Child                       Date

Signature of Parent/Legal Guardian      Date            Signature of General Manager             Date

                                               CHSPA, LLC 2009

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