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 24-48hrs 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 17th?

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* 8. What days and time range are you available the week of May 24th?

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* 9. What days and time ranges are you available Week of May 31st?

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* 10. What days and time ranges are you available Week of June 7th?

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* 11. What days and time ranges are you available week of June 14th?

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* 12. What days and time ranges are you available week of June 21st?

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* 13. What days and time ranges are you available Week of June 28th?

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* 14. What days and time ranges are you available Week of July 5th?

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* 15. What days and time ranges are you available week of July 12?

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

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* 17. What days and time ranges are you available week of July 26th?

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* 18. What days and time ranges are you available week of Aug 2nd?

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* 19. What days and time ranges are you available Week of Aug 9th?

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* 20. What days and time ranges are you available Week of Aug 16th?

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* 21. What days and time ranges are you available week of Aug 23rd?

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* 22. What days and time ranges are you available Week of Aug 30th?

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

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

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