Swimmer and Parent Information

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1. Parent or Guardians Name (first and last)

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2. Email

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3. Phone Number

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4. Swimmer Name (first and last)

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5. Swimmer Age

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6. Choose the times that you would prefer to have your lesson during, currently private lessons can only be taught 6-7pm Monday-Friday and Sundays 1-6pm

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7. Request an instructor (we will do our best to accommodate this)

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8. Please provide a brief description of what you would like your swimmer to work on as well as other comments or concerns.

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