EmailMeForm
Survival Swim - Swimming Registration
Please complete the form below to schedule your first swimming lesson.
After completion, a Spoga Team member will reach out to schedule.
Managed by Hailey Gross
Membership Director
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Name
First
Last
Child's Name
First
Last
Phone
*
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Age of child (or name of sibling)
Email
Credit Card
*
Card Number
Expiration
MM
/
YY
CVV
What is this?
3 or 4 digit number printed on the back/front of your credit card
For questions or immediate assistance, please send text to our Membership Team.
985-345-2453
All accounts are managed by Spoga Fitness Center.
Please allow 24 hours for update to process.
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Liability Waiver:
I understand that I risk injury and even death if I participate in aerobic and other exercise programs which involve using any and/or all of the services, equipment, machinery and facilities at Spoga Inc. if :
1. A medical doctor has not first determined that I am physically fit to participate: and
2. I participate in exercise/fitness activities or use equipment and /or facilities without first being
instructed by Spoga staff in the correct way to participate in the activities or use of the equipment.
I realize that I, not Spoga Inc., am responsible for having my own health evaluated before I participate in any exercise program, and for receiving instruction from Spoga’s staff before using any of the services, equipment or facilities. Unless, I notify Spoga in writing to the contrary, I understand and agree that Spoga is entitled to assume my physician has approved for my own participation in the exercise/fitness activities I participate in, and that I have received instruction form Spoga staff on the correct way to use any service, equipment and/or facility at Spoga Inc.
With the full knowledge of the risks involved in participating in aerobic and/or exercise programs and using Spoga’s services, equipment and/or facilities, and in consideration of my membership at Spoga, I release Spoga Inc., its members, employees and agents, from any responsibility for damages losses or injuries I suffer while participating in any aerobic and/or exercise program, or using any equipment and/or facility at Spoga Inc. I also agree to defend any claim or lawsuit, pay all attorney’s fees and costs, indemnify and hold harmless Spoga Inc. , its members, employees, and agents from any and all liability, claims and/or demand for damages, injuries, death, losses, costs, or expenses of any kind resulting from or which are claimed to have resulted from anyone admitted to Spoga as my guest or my own participation in any aerobic and/or exercise program or use of any equipment and/or facility of Spoga Inc.
I understand that all spa services vary in result based on the individual. I acknowledge that there are potentially dangerous conditions that are present when receiving spa treatments. I also understand that Spoga, Inc. is not responsible for any allergic reaction you may encounter from stylists and/or The Power Bar products.
I acknowledge receiving, and reading, and do understand the agreements contained herein, including the release of liability and hold harmless obligations.
I authorize Spoga Inc. to verify the information contained in this membership application and agreement.
Please sign below:
Signature
*
Clear
Are you a member?
Yes
No
Please select a package:
20 Lessons ($655 Member/ $700 Non Member)
10 Maintenance Lessons ($350)
Preferred Day/Time for lessons:
Total
$1.00