Simmons Swim Lessons 2026

Simmons Swim Lessons 2026

For athletes with visual and mobility impairments. Sundays, 10:30-12:00 at Simmons University
Athlete Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please describe your/your child's disability
Primary Parent/Guardian Name (if applicable)
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email
example@example.com
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Second Parent/Guardian or Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Email
example@example.com
Questions/comments/additional info
All Adaptive Sports New England athletes must complete our waiver annually. If you have not completed the waiver in 2026, please go to https://www.waiverfile.com/b/AdaptiveSportsNewEnglandInc/.
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