Interested in Youth Swim Lessons
Thank you for your interest! Your answers will help us with the registration process.
Parent Name
*
First Name
Last Name
Parent e-mail
*
Parent phone number
*
-
Area Code
Phone Number
My child is a
*
Member
Non-member
I am interested in lessons for the
*
Spring (April - May)
Summer (June - August)
Fall (September - December)
Winter (January - March
I am interested in
*
Group Lessons (ages 30 months - 17 years)
Private / Semi-private Lessons (ages 30 months - 17 years)
Little Seahorses (ages 6-29 months with a parent)
utm_source
utm_medium
utm_campaign
utm_term
Back
Next
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
No experience
Belly float independently
Back float independently
Swim/float/swim independently
Swim freestyle with side breathing
Swim backstroke
Tread water
Dive
Swim breaststroke
Swim more than one length of the lap pool unassistend
Swim butterfly stroke
What days/times work best for you? Select all that apply below.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
No experience
Belly float independently
Back float independently
Swim/float/swim independently
Swim freestyle with side breathing
Swim backstroke
Tread water
Dive
Swim breaststroke
Swim more than one length of the lap pool unassistend
Swim butterfly stroke
What days/times work best for you? Select all that apply below.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
No experience
Belly float independently
Back float independently
Swim/float/swim independently
Swim freestyle with side breathing
Swim backstroke
Tread water
Dive
Swim breaststroke
Swim more than one length of the lap pool unassistend
Swim butterfly stroke
What days/times work best for you? Select all that apply below.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
No experience
Belly float independently
Back float independently
Swim/float/swim independently
Swim freestyle with side breathing
Swim backstroke
Tread water
Dive
Swim breaststroke
Swim more than one length of the lap pool unassistend
Swim butterfly stroke
What days/times work best for you? Select all that apply below.
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
Additional comments, questions, or goals
Submit
Should be Empty: