Registration Form- One Per Family

1) Please answer the following questions below to complete swim lesson
registration. 
2) Please check off all the dates/time ranges you are available for. 
3) If there is anything specific you would like us to know please include in the notes section
4) Please allow us time to respond back to you with confirmed lesson dates 
5) Once lessons are confirmed we will issue you a invoice to complete payment and secure your dates for the summer

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* 1. Full Name of Student and Age? (Please list all students)

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* 2. Name of Parent or Guardian?

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* 3. What is your email address?

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* 4. What is your phone number?

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* 5. Address of Pool?

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* 6. Lesson Package of Choice?

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* 7. What days and time ranges are you available Week of May 27th?

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* 8. What days and time ranges are you available Week of June 3rd?

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* 9. What days and time ranges are you available week of June 10th?

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* 10. What days and time ranges are you available week of June 17th?

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* 11. What days and time ranges are you available Week of June 24th?

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* 12. What days and time ranges are you available Week of July 1st?

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* 13. What days and time ranges are you available week of July 8th?

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* 14. What days and time ranges are you available week of July 15th?

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* 15. What days and time ranges are you available week of July 22nd?

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* 16. What days and time ranges are you available week of July 29th?

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* 17. What days and time ranges are you available Week of Aug 5th?

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* 18. What days and time ranges are you available Week of Aug 12th?

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* 19. What days and time ranges are you available week of Aug 19th?

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* 20. What days and time ranges are you available Week of Aug 26th?

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* 21. Please advise of any health conditions or disabilities that we should be aware of before your child's lessons occur.

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* 22. Any additional information you would like us to know about?

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