2017 Lifeguard Rehire Training Registration

This information must be completed in order to attend a lifeguard training for the 2017 season. If you just show up to a training without clearing it with Hope Walker you will be turned away. You will also receive a follow up email for the class. You now must register for the course and create an online account the directions for this process will come prior to the course. Do not forget to reference the registration deadline for training. We must have all staff registered through the system.

If you need immediate assistance please email Hope Walker at hopewalker@rockfordparkdistrict.org. This is the best way to get a hold of me.

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* 1. Please enter the information indicated below:

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:

Last Name:

Email Address:

Zip Code:

Home Phone:

Cell Phone:

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* 2. Date of Birth:

Date:

Date

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* 3. Choose location(s) that you will be working:

Alpine Pool

Harkins Pool

Magic Waters

Sand Park Pool

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* 4. Please select which training session you will attend. By selecting a date, you are committing to attend that training. Failure to attend training will affect your employment with the Rockford Park District. All trainings will be held at Boylan High School. Please remember to bring your lunch.

December 17-18, 2016

March 4-5, 2017

March 18-19, 2017

April 1-2, 2017

April 29-30, 2017

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* 5. Primary Emergency Contact Information:

Name:

Relationship:

Day Phone:

Cell Phone:

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* 6. Secondary Emergency Contact Information:

Name:

Relationship:

Day Phone:

Cell Phone:

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* What School are you planning to attend next fall?

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* 8. Uniform Sizes

	S	M	L	XL	XXL
Lifeguard Tank Top (required)	Lifeguard Tank Top (required) S	Lifeguard Tank Top (required) M	Lifeguard Tank Top (required) L	Lifeguard Tank Top (required) XL	Lifeguard Tank Top (required) XXL
Lifeguard T-Shirt (required)	Lifeguard T-Shirt (required) S	Lifeguard T-Shirt (required) M	Lifeguard T-Shirt (required) L	Lifeguard T-Shirt (required) XL	Lifeguard T-Shirt (required) XXL

Thank you for completing the Lifeguard Training Information. If training date or location changes occur, you will be notified by email.

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* Swimsuit Size

Please feel free to go to Runner's Image to get sized prior to completing this survey. The size you select is the size that corresponds with your name at pick up. It can be very difficult to make adjustments after the fact. The orders are placed based on the suit size you select.

Runner's Image
219 E State St, Rockford, IL 61104
(815) 963-2171

Female 28

Female 30

Female 32

Female 34

Female 36

Female 38

Female 40

Female 42

Male S

Male M

Male L

Male XL

Male XXL

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* 1. Please enter the information indicated below:By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

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* 2. Date of Birth:

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* 3. Choose location(s) that you will be working:

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* 4. Please select which training session you will attend. By selecting a date, you are committing to attend that training. Failure to attend training will affect your employment with the Rockford Park District. All trainings will be held at Boylan High School. Please remember to bring your lunch.

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* 5. Primary Emergency Contact Information:

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* 6. Secondary Emergency Contact Information:

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* What School are you planning to attend next fall?

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* 8. Uniform Sizes

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* 1. Please enter the information indicated below:

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.