Interested in Swim Lessons
Thank you for your interest! Your answers will help us with the registration process.
Who would the lessons be for?
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Me (adult)
My child(ren)
Your Full Name
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First Name
Last Name
Your E-mail
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Your Phone Number
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-
Area Code
Phone Number
Zip Code
I am a
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Member
Non-member
I am interested in lessons for the
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Summer
Fall
Winter
Spring
I am interested in
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Group Lessons (Ages 30 months+)
Private / Semi-private Lessons (Ages 30 months+)
ISR (Infant Swimming Resource) (Ages 6 months - 6 years only)
Little Seahorses (Infant Toddler with Parent)
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Swimmer's Name
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First Name
Last Name
Swimmer's Age
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Has he or she enrolled in HAC swim lesson before?
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Yes
No
This swimmer can
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Belly float with face in water
Back float
Swim across pool on belly with arms and legs moving
Swim across pool on back with arms and legs moving
Swim freestyle with side breathing
Tread water
Jump into deep water
Dive
Swim breaststroke
Swim more than one length of the pool unassistend
No experience
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
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Belly float with face in water
Back float
Swim across pool on belly with arms and legs moving
Swim across pool on back with arms and legs moving
Swim freestyle with side breathing
Tread water
Jump into deep water
Dive
Swim breaststroke
Swim more than one length of the pool unassistend
No experience
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
Belly float with face in water
Back float
Swim across pool on belly with arms and legs moving
Swim across pool on back with arms and legs moving
Swim freestyle with side breathing
Tread water
Jump into deep water
Dive
Swim breaststroke
Swim more than one length of the pool unassistend
No experience
Add another swimmer
Swimmer's Name
*
First Name
Last Name
Swimmer's Age
*
Has he or she enrolled in HAC swim lesson before?
*
Yes
No
This swimmer can
*
Belly float with face in water
Back float
Swim across pool on belly with arms and legs moving
Swim across pool on back with arms and legs moving
Swim freestyle with side breathing
Tread water
Jump into deep water
Dive
Swim breaststroke
Swim more than one length of the pool unassistend
No experience
What days work for you?
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
And times?
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Early mornings (before 8:00 am)
Mornings (8:00 am - 12:00 pm)
Afternoons (12:00 pm - 4:00 pm)
Evenings (4:00 pm - 7:00 pm)
Do these days and times work for all swimmers listed?
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Yes
No
Please explain:
Additional comments, questions, or goals
Preferred length of lessons
15 minutes
30 minutes
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