Swim Lessons Session 5 Registration
July 31 - August 10. Twenty minute private lessons Monday - Thursday.
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Cabana Club Member?
*
Yes
No
If yes, what name is the membership under?
First Name
Last Name
Name of Swimmer
*
First Name
Last Name
Swimmer's Age
Gender of Swimmer
*
Male
Female
Other
Has Swimmer Had Lessons Before?
*
Yes
No
Please choose one private lesson time for your child.
*
Briefly Describe Student's Swimming Abilities:
*
What would you like the instructor to focus on teaching?
*
Comments or Additional Information:
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Private Lessons, General Individual Membership.
$
130.00
Private Lessons, Swim Lesson Only Membership.
$
175.00
Total
$
0.00
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