Semi-Private Lesson Request Form
Parent/ Guardian #1 Name
*
First Name
Last Name
Parent/ Guardian #1 Email
*
example@example.com
Parent/ Guardian #1 Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Swimmer #1 Name
*
First Name
Last Name
Swimmer #1 Age
*
Swimmer #1 Skill Level
*
Swimmer is new to the water or uncomfortable without a parent.
Swimmer is comfortable in the water but are not yet swimming independently.
Swimmer is beginning to swim independently.
Swimmer is swimming independently, but need to improve technique.
Swimmer has strong fundamentals who are learning all four competitive strokes.
Parent/ Guardian #2 Name (If Different)
First Name
Last Name
Parent/ Guardian #2 Email (If Different)
example@example.com
Parent/ Guardian #2 Phone (If Different)
Please enter a valid phone number.
Format: (000) 000-0000.
Swimmer #2 Name
*
First Name
Last Name
Swimmer #2 Age
*
Swimmer #2 Skill Level
*
Swimmer is new to the water or uncomfortable without a parent.
Swimmer is comfortable in the water but are not yet swimming independently.
Swimmer is beginning to swim independently.
Swimmer is swimming independently, but need to improve technique.
Swimmer has strong fundamentals who are learning all four competitive strokes.
Any additional notes you would like our team to know?
Submit
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