Welcome!

Get ready to swim with a Saturday family swim lesson centered on BIPOC and low-income youth (all are welcome)! Designed specifically for those with little or no swimming experience or water exposure. The 45-minute single day class is intended to teach water safety skills for both parents and children and includes 30 minutes of open swim with facilitated pool games. Includes free future swim lessons for youth participants. Each Jump Start Family Swim Lesson can accommodate a maximum of 4 families of up to 4 swimmers in each family. At least one adult (per family) must be in the water.

The following questions will help us gather information about interest in Jump Start swim lessons. If you have questions or would prefer to complete this application on paper, please contact NECC's Programs and Partnerships Manager, Emma Simons-Araya, at 503-284-3377 or programs@necommunitycenter.org.

We will reach out with more information soon
Information about You: This section provides us with information about how we can contact you and communicate about scheduling lessons.

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* 1. What is your name? (We'll ask information about the participants/swimmers below)

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* 2. What are your pronouns? (e.g., she/her, he/him, they/them, etc) (We'll ask for information about the participants/swimmers below)

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* 3. Please provide us with the following information (if you do not currently have a stable address or do not use email, enter N/A).

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* 4. Would you prefer we contact you by phone or email?

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* 5. What is your preferred language? If you need language or interpretation assistance in Spanish, we will connect you with our Spanish-speaking staff. If you need interpretation assistance in another language, please let us know and we will try to accommodate you.

Information about Adult Caregiver and Swimmer(s). Jump Start Swim lessons are BIPOC-youth centered with a focus on reducing drowning and improving safety in and around the water. All youth of all ages, races, genders, and swimming ability are welcome to participate.

We strongly encourage participation by adult caregivers and youth who are non-swimmers or those who have experienced trauma in and around the water.

Help us learn more about the participants from your household so we can support each swimmer and ensure a positive experience in the water. Please complete the following information for each youth swimmer from your household who would like to attend free Jump Start swim lessons. You will also be asked to provide the name an adult who will be in the water with the youth swimmer(s).

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* 6. Adult Caregiver Name (one adult per family must be in the water at all times during the lesson)

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* 7. Adult Caregiver Pronouns (e.g., she/her, he/him, they/them, etc)

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* 8. Adult Caregiver Birthday (must be 18 years old or older)

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* 9. Swimmer 1 Name:

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* 10. Swimmer 1 Pronouns (e.g., she/her, he/him, they/them, etc)

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* 11. Swimmer 1 Birthdate

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* 12. Would you like to register additional swimmers from your household?

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