Pricing / Schedule
Specifics
Policies & More Info
Waiver
Withdrawal Form
Past customers,
please click here
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Interest Form
First Name:
Last Name:
E-mail:
Phone:
Address:
City:
State:
--
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CA
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DE
FL
GA
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IL
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KS
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OR
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Zip:
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Swimmer(s) Info
This information allows us to recommend the appropriate class times and level.
Child's Name:
Birthdate:
MM
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Child's Gender:
--
Male
Female
Swimming & Water Comfort Level:
Fearful
Swims Underwater (without flotation)
Puts Face In
Swims Independently (without flotation)
Will Not Put Face In
Other
Availability
Preferred Class Times:
Please check all that apply.
Sat
Sun
Mon
Tue
Wed
Thu
Fri
Mornings
9:00am - Noon
Mid-day
12:00pm - 3:00pm
Afternoons
3:30pm - 4:30pm
Evenings
5:00pm - 6:00pm
Exceptions / Notes:
(worship, sports, after 1pm on Mondays, school hours, naptimes)
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