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Swimming Lessons - Enquiry Form
Please fill out the form to enquire for swimming lessons!
11
Questions
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1
Parent / Caregiver Name
*
This field is required.
First Name
Last Name
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2
Name of Swimmer/s
*
This field is required.
First Name
Last Name
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3
Email
*
This field is required.
We need this to be in communication with you!
example@example.com
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4
Phone Number
*
This field is required.
Please provide best phone number for WhatsApp communication
Please enter a valid phone number.
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5
Age of Swimmer
*
This field is required.
Beginner Baby (3 months - 12 months)
Baby (12 months - 18 months)
Beginner Toddler (18 months - 2 years)
Toddler (2 years - 3 years)
Beginner Child (3 - 4 years)
Beginner Child (4+ years)
Child (4 years +)
Beginner Adult
Competent Adult
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6
Ability
*
This field is required.
Please pick the relevant abilities of the swimmer (without a puddle jumper/floatation device)
Completely new to the water
Nervous / Apprehensive / Scared of the water (doesn't like to be in/under the water)
Happy in the water (Likes the water, can be submerged)
Wants to swim but can't (Happy to swim away from you/tried to swim alone)
Needs water safety knowledge
Competent in the water (can swim & breathe safely across a pool)
Needs stroke development (3 years +)
Has had a previous drowning / falling-in incident
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7
Other Information
Please provide any other information you would like us to know, or to enquire about. Exact age, swimming experience, detailed house locations, specific lesson enquiries, allergies etc
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8
Lesson Type
*
This field is required.
Private (1 swimmer)
Semi Private (2 swimmers)
Small Group (3 swimmers)
Group Lesson (4 swimmers)
Adult Beginner Group Lesson
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9
Do you have access to a pool?
*
This field is required.
Please state location on next slide.
YES
NO
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10
Lesson Location
*
This field is required.
Please state the location of your pool, or alternatively where you are based if you need access to a pool
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11
Ideal Day / Time
*
This field is required.
Please pick a variety of days and times that suit you.
Tuesday Morning (7am - 11am)
Tuesday Midday (12 - 2:45pm)
Tuesday Afternoon (2:45pm - 7pm)
Wednesday Morning (7am - 11am)
Wednesday Midday (12pm - 2:45pm)
Wednesday Afternoon (2:45pm - 7pm)
Thursday Morning (7am - 11am)
Thursday Midday (12pm - 2:45pm)
Thursday Afternoon (2:45pm - 7pm)
Friday Morning (7am - 11am)
Friday Midday (12pm - 2:45pm)
Friday Afternoon (2:45pm - 7pm)
Saturday Group Early Morning (7am - 10am) ***LIMITED SPACE
Saturday Group Midday Morning (10am - 1pm) ***LIMITED SPACE
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12
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