Porpoise Swim Lessons Interest Form

Porpoise Swim Lessons Interest Form

We regularly receive requests from swim team parents and others in the community for reliable, high-quality swim lessons. The launch of our Intro to Swim Team program last year was a partial response to the need we hear. Now we are preparing to launch group lessons for swimmers who need more instruction than that program offers. We plan to start small this summer, but our goal is to grow into a full service swim school. Please help us plan our launch by completing this interest form. We'd love it if you'd share with anyone you know who might be interested! As always, thank you for your support of the Portland Porpoises! Please complete one form per student.
Parent/Guardian Contact Information
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Please enter a valid phone number.
Who referred you? or how did you hear about us?*
Student Info
Name*

First NameLast Name
Birthday (MM/DD/YYYY)*
Gender*
Current Grade*
Current Grade*
How would you describe the student's relationship to water?*
Student Lesson Experience
Has your swimmer taken swim lessons?*
If "no", skip to the next session.
Where has your swimmer most recently taken lessons?
Other Lesson Provider:
For how long has your swimmer taken lessons?
What level of lessons did the student complete?
When was their last lesson?
Student's Skill Level

Please do you best to answer. This information will simply help us understand and plan for the needs of interested students. A full in-person assessment will be done for placement.*

	Definitely	Maybe	Probably Not	Don't know
Will walk independently and with ease to a swim instructor
Will consistently hold onto the wall or wait their turn on a step
Put their face in the water
Can bob (whole head under water) repeatedly
Can float on back or front
Jump into the water and surface independently
Comfortable in deep water
Can push off a wall and swim a short distance back to an instructor without without assistance (instructor support, pool noodle or bubble)

When are you hoping to start lessons?

SummerFall
Anything else we should know?
If you have questions about swim lessons or the Porpoises swim club, please email registrar@portlandporpoises.com.
Is your child fully potty-trained and does not need a swim diaper?
Should be Empty:

Porpoise Swim Lessons Interest Form

Parent/Guardian Contact Information

Student Info

Student Lesson Experience

Student's Skill Level