Swim Lesson Registration
Register for upcoming swim lessons with Akilli's House by providing your details below. All swim lessons take place in Enterprise unless provider and caregiver arrange an alternative location. Following registration policies and prcedures will be emailed to the provided email address.
Participant's Full Name
*
First Name
Last Name
Participant's Age
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Swim Experience Level
*
Please Select
Beginner
Intermediate
Advanced
Other
Preferred Lesson Days/Times
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Special Needs and Adaptive Swimming
Yes, I have special needs and require adaptive swimming
No, I do not have special needs
Please provide details about your adaptive swimming needs
Do you have an alternative location request?
Yes
No
If yes, please enter the city for the alternative location
Register
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