Ernie Els #GameON Autism MARINO Adaptive Aquatics Certification Program

Name(Required)

First Last

Email Address(Required)

Phone(Required)

Swim Instructor Certification(Required)

Max. file size: 128 MB.

Please upload documentation of your Swim Instructor Certification. The certification must be valid and active at the time of submission.

Swim Instructor Certification Expiration Date(Required)

Enter the expiration date listed on your Swim Instructor Certification. To proceed, your certification must be active and valid through the date of submission.

CPR Certification(Required)

Max. file size: 128 MB.

Please upload documentation of your current CPR Certification. The certification must be valid and active at the time of submission.

CPR Certification Expiration Date(Required)

Enter the expiration date listed on your CPR Certification. To proceed, your certification must be active and valid through the date of submission.

A Capital Campaign for the RECREATION COMPLEX