Samantha's Swimming Waitlist

Samantha's Swimming Waitlist

Please fill out this form to join our waitlist in the interim of trying to find a replacement for Appointments-Plus. You must complete at least 1 summer session before being considered for lessons during the school year.
Appointments-Plus is failing us with maintaining our waitlist. While we wait for our new app to be created, please fill out this form to join our waitlist!
What type of client are you?

Joining from Appointment-Plus waitlist New Client Returning client, not currently on waitlist
Date originally joined the waitlist on Appointments-Plus (please reach out if you are unsure):

Month Day Year
Don't worry if you are unsure, just finish filling out the form!
Parent/Guardian Information
Parent/Guardian Name

First Name Last Name
Parent/Guardian Phone Number
Please provide a number to receive text.
Parent/Guardian Email
example@example.com
Please tell us who referred you:
If referred by a friend, who can we thank?
Child(ren) Information
Swimmer Name

First Name Last Name
Date of Birth

Month Day Year
Date
School & Grade Level
Swimmer Name

First Name Last Name
Date of Birth

Month Day Year
Date
School & Grade Level
Swimmer Name

First Name Last Name
Date of Birth

Month Day Year
Date
School & Grade Level
Please leave us notes of your availability, child's swim abilities, etc.
Days available (chose all available):

Monday Tuesday Wednesday Thursday Friday Saturday
Time(s) available (chose all available):

8:30-12:30 12:30-3:30 3:30-6:30
Please provide us with as much information as possible in regards to scheduling or necessary notes:
The more information you provide, the quicker we can get you scheduled!
Should be Empty:

Samantha's Swimming Waitlist

Parent/Guardian Information

Child(ren) Information

Please leave us notes of your availability, child's swim abilities, etc.