Adult Swim Lessons

First and Last Name *

Age *

Cell phone # *

Current Swim Status, check all that apply *

I'm scared to put my face under water

I can "swim" but don't really think I'm doing it right

I'm a beginner and need to learn the basics

Any issues I need to know about with your swim *

Payment is expected the day of service or the 1st of the month if paying for more than one lesson. Please check if you can agree to this policy. *

I agree to pay fees on the day of service.

Required