Private Swim Lesson Interest Form

PRIVATE SWIM LESSON INTEREST FORM

This is an interest from and does not guarantee a private lesson.
Guardian Information
Name of Guardian*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

Participant Information
Name of Participant*
Participant Gender
Participant Age*
What is the participant's swimming experience*
Can the participant*

Blow bubbles out of their noseFloat unassisted in the waterKeep a horizontal position when swimmingNone of the above
Desired number of lessons*

4 (Member $100, Non-Member $115)6 (Member $150, Non-Member $165)
Does the participant need a guardian/paraprofessional in the water?*

YesNo
Does the participant have any needs regarding teaching methods*

PRIVATE SWIM LESSON INTEREST FORM