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2021 Swim Lesson Interest Form
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* Indicates required question
Email
*
Your email
Parent Name
*
Your answer
Phone Number
*
Your answer
Can we text on this number?
*
Yes
No
Swimmer #1 name
*
Your answer
Swimmer #1 age
*
Choose
2
3
4
5
6
7
8
9
10+
Swimmer #2 name
Your answer
Swimmer #2 age
Choose
2
3
4
5
6
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8
9
10+
Swimmer #3 name
Your answer
Swimmer #3 age
Choose
2
3
4
5
6
7
8
9
10+
Swimmer #4 name
Your answer
Swimmer #4 age
Choose
2
3
4
5
6
7
8
9
10+
Swimmer#5 name
Your answer
Swimmer #5 age
Choose
2
3
4
5
6
7
8
9
10+
I would like.....
Private lesson (1 student-$125)
Semi private (2 swimmers-$100/per swimmer)
Group (3-6 swimmers-$75/per swimmer; we will be forming groups if you do not have a group)
I am interested in/Available the week of...
July 5th
July 12th
July 19th
July 26th
August 2nd
I need a time slot in the...
*
Morning (11am-1pm; NOTE-we can not start before 11am)
Afternoon (1-4pm)
Evening (4pm-??; Note-dependent on swim team season/meets/etc)
Required
Send me a copy of my responses.
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