Swim Lesson Absences
Name of Parent/Guardian
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
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How many swimmers in Private Lessons (ages 3+)?
*
0
1
2
3
Name of Swimmer #1 in Private Lessons
*
First Name
Last Name
Name of Swimmer #2 in Private Lessons
First Name
Last Name
Name of Swimmer #3 in Private Lessons
First Name
Last Name
Which swim lesson day(s) AND time(s) will they be absent?
*
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How many swimmers in the Parent & Me Swim Class (12-36 months)?
*
0
1
2
Name of Swimmer #1 in Parent & Me Class
*
First Name
Last Name
Name of Swimmer #2 in Parent & Me Class
First Name
Last Name
How many Parent & Me Classes will you miss?
*
1
2
3
4
5
Date of Class #1 you'll be absent
-
Month
-
Day
Year
Date
Date of Class #2 you'll be absent
-
Month
-
Day
Year
Date
Date of Class #3 you'll be absent
-
Month
-
Day
Year
Date
Date of Class #4 you'll be absent
-
Month
-
Day
Year
Date
Date of Class #5 you'll be absent
-
Month
-
Day
Year
Date
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