Swim Lesson Sign-Up Form for Andre V Seldon Jr Foundation

Swim Lesson Sign-Up Form for Andre V Seldon Jr Foundation

Register here to get on the wait list for free swim lessons and learn more about the program.
We are enrolling for July 2026 classes.

Classes run for one entire month - two sessions per week.

Wednesday evenings 8pm - 8:50pm and Saturday afternoons 1pm-1:50pm - more details to follow once you are called for registration. There is a $25 donation reuqired to secure your childs spot, a link will be provided at that time.
Participant's Full Name

First NameLast Name
Participant's Age
Parent or Guardian Name

First NameLast Name
Parent or Guardian Email
example@example.com
Parent or Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the participant have any medical conditions or allergies?
How did you hear about the swim lessons?
Should be Empty: