Swim Lessons Registration

Please select the sessions you would like to register for *

Session 1 (8 lessons)

June 11 – June 21, Monday through Thursday

Beginner, 1:00 – 1:30 PM, Matt
Advanced Beginner, 1:30 – 2:10 PM, Matt
Intermediate, 2:15 – 3:00PM, Matt

Session 2 (12 lessons)

June 25 – July 12, Monday through Thursday

Beginner, 1:00 – 1:30 PM, Matt
Advanced Beginner, 1:30 – 2:10 PM, Matt
Intermediate, 2:15 – 3:00PM, Matt

Session 3 (8 lessons)

July 16 – July 26, Monday through Thursday

Beginner, 1:00 – 1:30 PM Matt
Advanced Beginner, 1:30 – 2:10 PM, Matt
Intermediate, 2:15 – 3:00PM, Matt

Morning Lessons

June 12 – July 26, $25 per lesson

Beginner, Monday through Thursday, 10:00 – 10:30 AM Mame/Charlie
Advanced Beginner, Monday through Thursday, 11:00 – 11:30 AM Mame/Charlie

Make-up lessons are available for cancellations due to inclement weather only. Classes will be cancelled if air temperature is below 60°or for severe weather. Please check the website one hour prior to lesson if unsure about the weather.

First Name*

Last Name*

Bond Number*

Birthdate*

Gender*

Primary Phone*

Email*

Secondary Email

Emergency Contact Name*

Emergency Contact Phone*

Pediatrician Name*

Pediatrician Phone*

Insurance Policy Number*

Name of Insured*

Previous Experience

Select all of the below conditions that apply*

If you select anything other than "None", please provide more information in the "Additional comment" box below.

Previous Injury
Current Medications
Physical Limitations
History of Blackouts
Allergies
Corrective Eyeglasses
None

Additional Comments