Evaluation Form and Waitlist
Parent Name
*
Last Name
Child/Childrens Names
Age(s)
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Type of Lesson Requested
*
Bootcamp Style Swim Lessons
How many children would you like to sign up?
*
1
2
3 or more
Preferred time of day for lessons?
*
Morning (8:30-12:30)
Mid-Day (12:30-2:00)
No Preference
Location for lessons?
*
Doss Swim's heated pool in Towne Lake area of Woodstock
Your private pool (cost depends on added drive time)
Time of year prefer lessons?
*
Spring while school is in session
Summertime
Fall while school is in session
Has your child had swim lessons before?
*
Yes
No
Has your child been in a puddle jumper or life jacket often?
*
Yes
No
Life Jacket only for lake boat usage
Does your child like to put their face in the water?
*
Yes
No
Only while using googles
Do you have access to a pool to continue practicing between lessons?
*
Yes
No
Does your child have any special needs or behaviors (sensory, etc.) we need to accommodate?
*
Yes
No
Please provide any additional information that you think is important.
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