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Swim Lesson Participant Questionnaire
Please fill out the information below in regard to your swimmer registered with the Iron Works Health Club Swim Program.
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* Indicates required question
Swimmer Name (First and Last name)
*
Your answer
Parent/Guardian Name
*
Your answer
Parent/Guardian Phone number
*
Your answer
Email Address
*
Your answer
Does your swimmer have experience in the water?
Yes
No
Clear selection
If yes, what have they done in the past?
Your answer
Have you participated in Swim Lessons at IWHC?
*
Yes
No
If yes, and you would like to work with a specific Swim Instructor, please let us know who. (Instructor placement is not guaranteed, but we match your swimmer with the instructor that best fits their needs)
Your answer
When are you hoping to schedule appointment times?
*
Morning (8-10am)
Mid-Day (11am-1pm)
Afternoon (1-5pm)
Evening (after 5pm)
Are there any days that are off limits for scheduling? (Monday-Friday)
Your answer
Which package do you prefer?
10 Session Package
5 Session Package
1 Session Package
30 minute Lessons
45 minute Lessons
60 minute Lessons
10 Session Package
5 Session Package
1 Session Package
30 minute Lessons
45 minute Lessons
60 minute Lessons
Clear selection
Is there any other information instructors would need to know about your swimmer that may come up during a lesson? (allergies, fears, etc.)
Your answer
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