Dive & Thrive – Drop-In Swim Lessons Interest Form

Dive & Thrive – Drop-In Swim Lessons Interest Form

Thursday, July 10th, 2025 – Temple University Ambler Campus 4:00PM - 7:00PM
Site Address:

Temple University Ambler Campus

580 Meetinghouse Road, Ambler, PA 19002
Full Name (Participant)*

First NameLast Name
Age (Participant)*
Guardian Name (if under 18)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Group Swim Lesson - $20.00/personPrivate Swim Lesson - $35.00/personOther
4:00PM - 4:30PM4:30PM - 5:00PM5:00PM - 5:30PM5:30PM - 6:00PM6:00PM - 6:30PM6:30 PM - 7:00 PM
Beginner (Non-Swimmer)Some experience (can float, basic strokes)Intermediate SwimmerAdvanced swimmer (training or refinement)Other
YesNoMaybe
Session 1: July 15 – July 26Session 2: July 29 – August 9Session 3: August 12 – August 23I’m not sure yet
Social MediaWord of MouthSchool or CampFlyerOther
Anything you'd like us to know (medical conditions, goals, accessibility needs, etc.)
Dive & Thrive will collect all payments onsite at the event.

You may pay using any of the following methods:
- Credit or Debit Card
- Cash
- Venmo: @diveandthrivehq
- CashApp: $diveandthrivehq
- PayPal (available upon request)
After submitting this form, you’ll receive a confirmation email with payment reminders and next steps.

Please arrive a few minutes early to complete check-in and payment before your lesson begins.

If you have any questions please email, swimlessons@diveandthrive.org
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