JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Group Swim Lesson Registration Form
Please take a moment and fill out this form. This information is required to complete your registration. Your child can not attend swim lessons if this form is not completed.
If you have any questions, please contact Jordan Helmick at
jhelmick@zoominternet.net
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Parents Name
*
Your answer
Membership #:
*
Your answer
Parent's Email Address
*
Your answer
Parent's Phone Number
*
Your answer
Name of Swimmer
*
Your answer
Age of Swimmer
*
Your answer
What session did you register your child for?
*
Session 1
Session 2
Session 3
What level did you register your child for?
*
Level I (Water Exploration) – Teaches children with no previous swimming experience water adjustment and basic supported swimming skills
Level II (Primary Skills) – Emphasizes underwater exploration, unsupported locomotion, front and back combined stroke and jumping into the water without help.
Level III (Stroke Readiness) – Teaches front crawl, diving, elementary backstroke and back crawl.
Level IV (Stroke Development) –Teaches side-stroke and breast-stroke, stressing form, coordination and endurance
Level V and VI (Stroke Development, Personal Water Safety, Fitness Swimmer) – Teaches butterfly kick, underwater swimming skills and mastery of stroke skills.
Swim Level or Experience
*
Your answer
Any additional information about swimmer that you would like the instructors to know.
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
