Pool Rolling Registration Pool Rolling Registration/Waiver Come join us at the indoor pool in Rockville! The indoor pool is the perfect place to work on your roll, learn a new roll, or work on your freestyle flat water tricks. The warm, heated indoor pool is a great place to practice all these kayaking skills when it’s cold outside. The indoor pool is also a perfect place to take a beginner lesson! Classes are small, fun, and taught by our expert ACA certified instructors. All kayaks and gear are included (if needed) for lessons. Lessons are just $100 All are welcome to join us: Kids, parents, students, – Anyone who wants to practice or learn kayaking skills in a warm, cozy, friendly environment. You can practice on your own, or take a lesson from one of our expert instructors. Our indoor pool sessions begin in November. Parent's should plan to accompany children under 10, unless otherwise approved by instructor Practice On Your Own: ✓ $20 per session (with your own gear) ALL BOATS AND GEAR MUST BE CLEAN OF DIRT AND DEBRIS !!! ✓ $30 per session if you need us to provide gear for you- please fill out the information below on weight and height so we can provide the correct size boat ✓ Buy a package of 6 sessions for $100- (no instruction included in practice sessions) Need Instruction? ✓ $100 per 2hr lesson with the best instructors in the DC area. ✓ We can teach you rolling (any kind of roll), strokes, bracing, you name it! Instruction Package: ✓ 3 lesson package for $240 (gear included if needed) ✓ Space is limited, so sign up now! Sessions are Saturdays, 4p - 6:30p at the Rockville Swim & Fitness Center 355 Martins Lane, RockvillePool Rolling Sessions Saturday 2/1 - $20 ($30 if equipment is needed) Saturday 2/8 - $20 ($30 if equipment is needed) Saturday 2/15 - $20 ($30 if equipment is needed) Saturday 2/22 - $20 ($30 if equipment is needed) Saturday 2/29 - $20 ($30 if equipment is needed) To book a private lesson for the date(s) chosen above, check here. After submitting this form contact Evelyn McEwan @ 301-213-9548 Yes, I want to book a Private Lesson! Participant InformationName* First Last Phone #*Email* Date of Birth* MM DD YYYY Age*Equipment* I need Equipment I'm Bringing my own Height for Kayak Sizing*Weight for Kayak Sizing*Health Information*Emergency Contact InformationEmergency Contact Name* First Last Emergency Contact Phone*Assumption of Risk, Release, and Waiver AgreementI acknowledge that participating in classes taught by the Valley Mill Kayak School (VMKS) involves exposure to risks beyond the control of Valley Mill Camp inc., directors, and staff. I hereby agree that the sport of white-water kayaking can be dangerous and expose participants to risks and hazards including but not limited to immersion in cold water, drowning, inclement weather, slipping and falling, falling objects, and suffering injury in remote areas where help may not be readily available. I further acknowledge that such risks may cause serious personal injury, or even death.* By checking here you agree that you read and understood the statement above. While I recognize that VMKS instructors make every reasonable effort to minimize exposure to known risks, some risks can not be anticipated. I understand that I have a personal responsibility to learn and follow safety rules and procedures my instructors establish. I acknowledge that I am responsible for making them aware at any point if I question my own knowledge of these procedures or my ability to participate in any activity.* By checking here you agree that you read and understood the statement above. I have no physical, mental or medical condition that would adversely affect my ability to participate in the VMKS program or that would affect my safety or the safety of the group. I agree to inform VMKS of any such physical, mental, or medical condition should one develop in the future.* By checking here you agree that you read and understood the statement above. I understand and agree that in participating in the VMKS program or using the equipment or facilities of VMKS or receiving the instruction of VMKS there is the possibility of accidental or other physical injury. I agree to assume the risk of such injury and further agree to indemnify VMKS, Valley Mill Camp Inc., Seneca Joint Venture and all of their agents, employees, directors, officers, affiliates, successors, and assigns (collectively “Valley Mill Camp”) and also the National Park Service from any and all liability as a result of my use of the facilities, equipment and instruction offered by VMKS.* By checking here you agree that you read and understood the statement above. It is expressly agreed that all use of the equipment, facilities and instruction of VMKS shall be at my own sole risk. I further agree that Valley Mill Camp shall not be liable for any injuries or damage to me or my property, or be subject to any claim, demand, or cause of action whatsoever, including, without limitation, injuries or damages resulting from negligence on the part of Valley Mill Camp.* By checking here you agree that you read and understood the statement above. I have carefully read this Release, Waiver, and Assumption of Risk Agreement and fully understand its contents.* By checking here you agree that you read and understood the statement above. Electronic Signature Agreement -You are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.* By checking here you agree that you read and understood the statement above. Signature of Participant First Last If Participant is under 18, signature of Parent or Guardian is requiredI agree that I am the Parent or Legal Guardian of the Camper named above, that I am 18 years of age or older, and that I have the legal authority to grant this permission to Valley Mill Camp Inc* By checking here you agree that you read and understood the statement above. Signature of Parent or Guardian* First Last