American Red Cross Lifeguard Registration Form

Registration Date
Participant Name
Home Address
Home Phone
Alternate Phone
Preferred Method of Contact Home Phone Alternate Phone Email
Session/Dates (see Schedule)
Have you taken an American Red Cross Lifeguard course in the past? YES     NO

Do you have any reservations about completing the prerequisite 300 meter swim?

Do you have any health or other concerns that you would like noted that would impair your ability to complete the course requirements?

How did you hear about our program?


Please stop by the Dedman Center for more information or contact Lindsey Gavlick at 214-768-9916 or


Recreational Sports is a department in the Division of Student Affairs.