* Indicates a required field

Aqua Zumba Pre-Registration 8/1/2021

The Pinole Swim Center is Hosting Aqua Zumba on Sunday's  starting May 23, thru October 10th.  11 am to Noon.  Admission is $10.00.  At this time, payment will only be accepted online, as there will be no Refunds or credit. We must be able to pay the instructor for her time. No shows will be charged a $1 processing fee. 

Parent/Guardian Information

At least one parent/guardian registration is required.
New accounts will be sent an email confirmation message with instructions to setup a password.

At least one parent/guardian email address must be provided.
Check the boxes to indicate which parent/guardians should receive team-wide emails.

First Name * Last Name * Email Address *
Required for login
Primary Phone


+ Add another parent/guardian
Athlete Information

Enter the information for each athlete being registered below. At least one Athlete registration is required.

First Name * Preferred Name Middle Initial Last Name * Gender * Birth Date *
+ Add another Athlete
Home Address

COVID 19 Waiver

Liability Release Agreement

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 while participating in recreational swimming, and/ or swim workouts, events or other approved activities (collectively, the “Activities”), and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 and the Activities may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Pinole Seals Swim Team, And the City of Pinole, and their respective employees, volunteers, and program participants and their families (the “Released Parties”). I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to me (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I, may experience or incur in connection with my attendance at any of the Activities (“Claims”).

I agree that if I have a fever, cough, feel short of breath or am experiencing any other symptoms or have knowingly been exposed to a communicable disease such as COVID-19 or have traveled to or from a highly impacted area, I will not attend any of the Activities for at least two weeks after exposure or symptoms have subsided or I have returned from a highly impacted area. In addition, if I discover I have been exposed to a suspected or positive case of COVID-19 or have tested positive for COVID-19, I will notify the coach or club administrator immediately.

On my behalf, the behalf of my family, estate, heirs, or representatives, I hereby release, covenant not to sue, discharge, and hold harmless: Pinole Seals Swim Team, and the City of Pinole, and their officials, employees, agents, volunteers, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Pinole Seals Swim Team, and the City of Pinole, and their employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Activities. In addition, I agree to indemnify and hold harmless the Released Parties from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses and/or liabilities (including attorneys’ fees) arising either directly or indirectly from or related to any and all claims made by or against any of the Release Parties due to bodily injury, death, loss of use, monetary loss or any other injury from or related to the Activities whether caused by the negligence of the Released Parties or otherwise.

By signing below, I acknowledge and represent that I have read the foregoing waiver of liability, been given the opportunity to ask questions, fully understand its terms, and understand that I have given up rights by signing it, and sign it voluntarily as my own free act, including the release of liability and indemnification requirements contained in this document. I agree that this agreement shall be enforced as fully as possible and that any unenforceable provisions shall be deemed modified to the limited extent to permit enforcement.

Enter your initials to indicate acceptance: *
No show/cancelation policy

Due to the limited availability of the classes, there is no way to offer a credit for future classes.  Payment must be processed online and a $1.00 no show fee will be assessed. 

Enter your initials to indicate acceptance: *