Swim Lesson Sign Up Form


Please complete the form below and email to [email protected] or bring it the club house front desk.  If registering multiple children, please complete a separate form for each child.


Swim Lesson Form

Please circle your preferred time you would like swim lessons:          

                 Weekday:       Mornings           Afternoons              Evenings

Are you interested on Group or Private Lessons?   Group                     Private                   

Parents Name _________________________________

Best number to be reached  during the day ______________________________

Email address __________________________________________

Are you a current Haddontowne Swim Club Member?   Yes                No               

Childs First Name ___________________ Last Name ________________________

Age __________ Birth Date _______________ Has your child taken swim lessons before?                 

If yes were and when? ______________________________________________________

Please answer the following questions so we can put your child in the right group level.

Does your child have any fear of the water? ________________________________________

Can your child put his/her face in the water? _______________________________________

Can he/she blow bubbles in the water? ____________________________________________

Can he/she float? _____ If yes front and back or both? ___________________________________

Can he/she tread water? _______________________________________________________

Can he/she swim on their own at all, if so how far? __________________________________

What is your goal for your child to accomplish from these lessons?