2026 Private and Semi-Private Swim Lesson Registration Form

Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Participant's Name*

First NameLast Name

Birth Date

MonthDayYear

Please give a brief description of your chid's swim ability/experience

Lesson Choice

Private Swim Lesson (non-member)$36.00

30 minute private classes

Quantity

Private Swim Lessons (swim club members)$32.00

30 minute private lessons for swim club members

Quantity

Semi-private Lessons (non-member)$24.00

30 minute semi-private lessons. Must sign up with 1 or 2 other children listed below

Quantity

Semi-Private Lessons (swim club members)$20.00

Semi-Private Swim Lessons for swim club members. Must sign up with 1 or 2 other children listed below.

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

If you are enrolling in semi-private lessons please list the names of the other students you wish to have lessons with below

Name

First NameLast Name

Name

First NameLast Name

Please select the following options to better assist in scheduling your lessons. Someone will be in contact to set up your exact schedule.

AM lessonsPM lessons

Prefered Start Date

Date

2026 Semi-Private and Private Swim Lesson Form