• Special Needs Intake Form

    Special Needs Intake Form

    Welcome! Our mission is to allow children 3-11 years old with special needs to have fun while acquiring water safety and basic swimming skills.  The following questions will help us lead your child to swimming success! See additional information about pricing and guidelines on our website https://www.hubbardswim.com/privatelessons
  • All Special Needs classes are currently on a waitlist.

    Submitted forms will be contacted once we have a class available.
  • ENROLLMENT REQUEST

    Please choose your preferred location and check the time slots your swimmer can consistently attend throughout the year. Since our waitlist is long and timing is unpredictable, we ask that availability reflects all seasons.
  • SWIMMER'S BASIC INFO

  • MEDICAL INFORMATION

  • On location up to a 4T is available to purchase. 5T and larger swim briefs can be purchased at www.theraquatics.com

  • COMMUNICATION INFORMATION

  • BEHAVIORAL INFORMATION

  • CHILD INFORMATION

  • SWIM EXPERIENCE

  • PLEASE NOTE

  • Should be Empty: