Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Lifeguard Class Pre- Registration for 2022 season

  1. Participant Information
  2. Parent/ Guardian Information (Complete if participant is a minor)
  3. Emergency Contacts (please indicate 2)
  4. Which Certification do you need *
  5. Would like to participate in SPLASH program?*
  6. Email Acknowledgement *

    The City Recreation and Parks Department will contact you via email within 3 business days of lifeguard preregistration submission

    Please Check Spam and Junk Mail 

    If you do not receive an email please contact Heather Candelora:  heatherca@cityofws.org

  7. Waiver of Liability/ Photo
    Liability Waiver: I am/my child is participating in the American Red Cross training program and I release, absolve, clear, hold harmless and waive the responsibility of the City of Winston-Salem, Recreation and Parks Department, Staff and Volunteers of risks and hazards incidental to the implementation of this program. Photo Waiver: By participating in this public program, the participant (parent/guardian) acknowledges and gives permission for his/her (child/dependent) image/likeness to appear in group photos used by WSRP in promotional material (printed and/or social media).
  8. Type name of person who agrees to the above liability waiver- a signature will be required at the first class meeting
  9. Leave This Blank:

  10. This field is not part of the form submission.