Bubble Up Swim School Client Intake Form
Interested in swim lessons with Bubble Up Swim School for the swim season? Please take a moment to complete the Client Intake Form throughly. Once submitted, we will be in contact regarding availability and scheduling. 

For some reason, our emails do not seem to make their way to everyone! Please open your email now and add in alia@bubbleupswim.com to your trusted sender list to make sure you don't miss important communication from us. If after a few days of submitting this form you haven't heard back, please check your junk/bulk/spam folders before emailing alia@bubbleupswim.com or call or shoot us a text at 949-877-SWIM.

Effective Spring 2024 - any student that may be apprehensive and become upset by being in the water, working with a new instructor or swim lessons in general is now required to initially enroll in the Intensive Swim Program before registering for any other lessons. Parents will also need to remove themselves from their child's line of sight during lessons so as to not become a distraction. More info can be found at www.bubbleupswim.com under the FAQs. We appreciate your understanding and cooperation!
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Email *
Parent/guardian’s first name *
Parent/guardian’s last name
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Full mailing address, including city and zip code *
Cell phone
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Student’s first name, last name and age (enter information for every student, please)
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Preferred location for swim lessons (we're constantly on the lookout for additional pools so please let us know if you have or know of one we can potentially use with other swimmers) *
Required
If requesting your own pool, please provide address/city of location (major cross streets in fine)
If requesting your own pool, is there a guarded gate that needs to be entered to gain access to the community/pool?
Clear selection
Approximately how many lessons a week would you like?

(Effective Spring 2024 - any student that may be apprehensive and become upset by being in the water, working with a new instructor or swim lessons in general is now required to initially enroll in the Intensive Swim Program before registering for any other lessons.
For students already comfortable, we recommend two lessons a week, at the bare minimum, but understand that everyone may not be able to commit to that.)
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Preferred day(s)/time(s) for swim lessons (dependent on staff and location availability)?
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9am to 1pm
1pm to 4pm
4pm to 7pm
none
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Does your child attend a year-round school?
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For students with very specific availability, please enter requests here
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Any swim experience/hesitation?
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What are your swim goals for your student?
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Required
Any special needs to be aware of?
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Tentative start date for swim lessons (weather permitting)? We anticipate our season to begin the end of March/beginning of April.
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Tentative end date for swim lessons? We anticipate our season to conclude at the end of October.
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Any vacation dates or time away to account for?
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We are a swim school that is committed to getting every student water safe as quickly as possible. We don’t want either of us to waste each other’s time (not to mention the additional cost incurred with unnecessarily drawn out lessons). We know what needs to be done in order to achieve water safety and any student who is crying while attending lessons just once or twice a week is not making any progress towards becoming water safe.

Above all else, frequency and consistency are what quickly turn our students into capable, strong and independent water warriors. We are proud to offer our exclusive Intensive Swim Program, designed to propel your swimmer to the next level. Private 1-on-1 lessons will be held every weekday, Monday through Friday, for two back-to-back weeks, totaling ten lessons.

*The Intensive Swim Program is now required for swimmers who are apprehensive of the water/new environments/working with a new instructor (i.e. our criers) before registering for any other lessons.

Parents will also be required to remove themselves from their child's line of sight during lessons so as to not become a distraction, as the instructor is trying to gain trust from your student.

We understand not everyone may be able to commit to this timeline and ask for your cooperation in registering for this once your schedule allows.

The Intensive Swim Program is also a great option for those who may have regressed during the winter break or for students who want to kickstart their swim season.

Is the Intensive Swim Program something your student will need to be enrolled in or that you're interested in for those already comfortable in a swim lesson environment?

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Students between the ages of 3 - 17 need boundaries and structure to thrive and Bubble Up Swim School embraces an encouraging, yet no-nonsense approach. Students are expected to adhere to basic pool rules, such as no running on the pool deck, holding onto the wall with one hand when in the water, keeping their head above water unless instructed otherwise, as well as paying attention to their instructor during the lesson. To provide the best possible learning experience for your child(ren), and to ensure we are on the same page, we have a few questions regarding the environment in which your child(ren) has/have been raised.

For swimmers aged 3 - 17, has/have your child(ren) experienced behavioral issues with teachers or other instructors? If Yes, please explain in "Other"

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For swimmers aged 3 - 17, has/have your child(ren) been raised in an environment in which there are consequences for their actions? 

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For swimmers aged 3 - 17 raised in an environment in which there are consequences for their actions, is time-out a concept the student(s) has/have an understanding of?
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I understand that every student is individual and unique in their swim lesson progression. When presented with the same information, one student may excel faster than another. One student may have external challenges to overcome (i.e. working with a new adult, adjusting to being in a body of water) while another student loves being in the water and can't get enough of it. 

Bubble Up Swim School utilizes proven and consistent techniques with every student, however each student's water safety journey may be as distinctive and individualized as each and every student we encounter. 

With that being said, Bubble Up Swim School can not provide an estimation as to when your student will become water safe. In our experience, high frequency and consistency of lessons, as well as external practice time (outside of scheduled swim lessons) contribute to quicker results.
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I understand that as a parent/guardian of a new student, I may be asked to step out of my student's line of sight during a swim lesson, to not become a distraction (young students who are initially uncomfortable with their lessons are notorious for crying to attract their parent/guardian's attention to be "saved"). For students enrolled in the Intensive Swim Program, crying should subside within the first week. 
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How did you hear about Bubble Up Swim School? If a referral, whom can we thank? *
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