Linden Swimming Lessons at The Gateway Family YMCA

Linden Residents Youth (Ages 3-12) Swimming Lessons

Thank you for your interest in this program. Classes will be held at either our Union or Rahway locations. Please fill out the interest form below. Please note that submitting this interest form does not guarantee placement in the program. Slots are limited and this program is on first come first served basis, you will be contacted shortly if selected.

*1.These classes are only available for youth ages 3-12 who are Linden Residents. Do you certify your child meets this criteria?(Required.)

Yes

*2.Please select your child's age range?(Required.)

3-5 years old

6-12 years old

*3.Please select your preferred location (Please note that preferred location is not a guarantee)(Required.)

Rahway - 1564 Irving Street, Rahway, NJ 07065

Union - 201 Tucker Avenue, Union, NJ 07083

*4.Please select your preferred timeframe for lessons (Please note that preferred location is not a guarantee)(Required.)

Thursday 5p-5:30p

Thursday 5:30p-6p

Thursday 6p-6:30p

Thursday 6:30p-7p

7:30p-8p

*5.Please select the choice which best describes your child's swimming ability:(Required.)

Starters - No experience and uncomfortable in the water

Basics - Comfortable in the water and is able to submerge head under the water

Strokes - Is able to make forward progression in the water

*6.Please provide the participant's information:(Required.)

Full Name *

Date of Birth

Address *

City/Town *

ZIP/Postal Code *

Parent/Guardian Name

Email Address *

Phone Number *

*7.Race/Ethnicity(Required.)

African-American

Asian

Caucasian

Hispanic

Other

Prefer not to answer

*8.Gender(Required.)

Male

Female

NonBinary

Prefer Not to Answer

*9.I agree to all terms above(Required.)

Yes, I do

*10.Digital Signature of Parent/Guardian(Required.)

*11.Date of Digital Signature(Required.)

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