Swim Lesson Sign Up Form
Please complete the form below and email to the swim lesson instructor listed on the private lesson or group lesson tab above. 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?
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