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PARC Swim Waitlist
Please complete this form to be placed on our PARC Swim waitlist.
OK
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1.
Parent's full name
(Required.)
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2.
Parent's phone number
(Required.)
*
3.
Parent's email
(Required.)
4.
If a place becomes available, we will attempt to contact you by phone. When is the best time for us to contact you by phone?
9am - 11am
11am - 1pm
1pm - 3pm
3pm - 5pm
Not available
Mon - Fri
9am - 11am
11am - 1pm
1pm - 3pm
3pm - 5pm
Not available
Sat - Sun
9am - 11am
11am - 1pm
1pm - 3pm
3pm - 5pm
Not available
Comments
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5.
Children's full names
(Required.)
Child 1
Child 2
Child 3
Child 4
Child 5
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6.
Children's dates of birth
(Required.)
Child 1 - DOB
Child 2 - DOB
Child 3 - DOB
Child 4 - DOB
Child 5 - DOB
*
7.
Description of ability for each child
(Required.)
Child 1
Child 2
Child 3
Child 4
Child 5
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8.
Details of previous lessons for each child
(Required.)
Child 1
Child 2
Child 3
Child 4
Child 5
9.
Are there any special needs or special requirements that we need to be aware of? Please indicate each child's name and describe their requirements.
*
10.
Do you have any other children currently enrolled in PARC Swim?
(Required.)
Yes
No
Current Progress,
0 of 10 answered
