Parent/Guardian Full Name *
E-mail *
Mobile *
Child's Full Name *
Child's Date of Birth *
Child's Age *
Recommended Level *—Please choose an option—JellyfishTadpoleFrogGoldfishFlying FishDoryJunior SquadPrivateNot Sure - Please Advise
Preferred Day *—Please choose an option—MondayTuesdayWednesdayThursdayFridaySaturdayAny Day
Preferred Time *—Please choose an option—9:30 AM10:00 AM10:30 AM3:30 PM4:00 PM4:30 PM5:00 PM5:30 PM6:00 PMAny Time
Please note: Morning sessions (9:30 AM, 10:00 AM, 10:30 AM) are only available for Jellyfish, Tadpole, Frog, & Minnow levels on Tuesday and Thursday.
Previous Swimming Experience
Has your child had swimming lessons before? *
YesNo
If yes, where?
How long did they attend?
What level did they reach?
Current Swimming Ability
Please select all that apply:
Comfortable in waterCan put face in waterCan float on frontCan float on backCan kick with boardCan swim without floaties/aidsCan swim 10-25 metersCan swim 25+ metersKnows freestyleKnows backstrokeKnows breaststrokeNot comfortable in water yet
Any specific concerns or goals?
Enquiry/Message *
