Private Swim Lesson Interest Form

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.Format: (000) 000-0000.
Email*
example@example.com

Participant Information
Name of Participant*
Participant Gender
Participant Age*
What is the participant's swimming experience*
Blow bubbles out of their noseFloat unassisted in the waterKeep a horizontal position when swimmingNone of the above
4 lessons $1206 lessons $165
YesNo
Does the participant have any needs regarding teaching methods*

What are your goals for private swim lessons*
What days and times work best*
Any additional feedback
Do you have a swim instructor request?
Should be Empty: