2019 JCC Swim Lesson Inquiry Form
Thank you for your interest in swim lessons at the JCC. You must be a JCC member in good standing to take swim lessons. Please complete this form and a swim instructor will contact you to schedule your sessions. All payments must be made before the first swim lesson.

For more information, please contact kathleen@nojcc.org.

Swimmer Name (First and Last) *
Must be a current JCC member
Your answer
Age of Swimmer *
Your answer
Parent/Guardian Name (First and Last) *
Must be current JCC member
Your answer
Cell Phone Number *
You will be contacted at this number to schedule lessons
Your answer
Email *
Your answer
Do you want private or semi-private lessons? *
If semi-private, please name additional swimmer(s).
Please indicate who your swimmer with be sharing lessons with. Semi-private lessons are for 2-3 swimmers. All must be current JCC members.
Your answer
Has the swimmer taken lessons before? *
Instructor Preference
We will do our best to accommodate, but requests are not guaranteed. Please note that Coach Kat is not available for swim lessons at this time.
Your answer
Please list concerns that our swim instructors may need to know.
Your answer
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