Private Swim Lesson Request Form

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Private Swim Lesson Request Form - Burr Ridge

Five Seasons takes pride in having the area's most talented instructors who provide a safe, positive, and encouraging learning environment built on trust. *Please discuss helpful strategies and special considerations that will maximize your child's experience.

Private Swim Lesson Registration Instruction

1. Complete all information on the form and click submit.
2. Non-members must enter and exit the club in a timely manner before and after lesson (approx 30 minutes)
3. Non-members cannot use facility other than lessons.

4. Non-members are required to provide payment information prior to lessons beginning
5. Parent/Guardians please sign the Financial Responsibility Agreement below.
6. Lesson packages expire after 12 months.

7. Lesson packages cannot be refunded.

8. Facility Fee: Non-Members are subject to an Annual $40 Facility Fee per swimmer.

Main Contact Name *

Email Address *

Phone Number *

Address (City, State, Zip Code) CHICAGOLAND AREA ONLY *

Zip Code *

Are you a member or non member? *

Member

Non Member

How many participant's are you signing up? *

Participant #1 - Name *

Participant #1 - Birthdate *

YYYY

Participant #2 - Name

Participant #2 - Birthdate

YYYY

Day Time Preferences - 1st Choice *

Day Time Preferences - 2nd Choice *

Day Time Preferences - 3rd Choice *

Goals: *

Private Parent Tot

Learn to Swim

Learn/refine stokes/correct breathing

Competition/Goal of making Club Team

Required

Any exercise limitations, fears, biochemical considerations? *

Start date to begin lessons: *

YYYY

Previous or Preferred Instructor:

Lesson Pricing

Swim Package desired: *

Private Individual Lessons (4 x 30 min lessons) 4 pack

Private Individual Lessons (8 x 30 min lessons) 8 pack

Private Individual Lessons (12 x 30 min lessons) 12 pack

Semi Private Lessons (4 x 30 min lessons) 4 pack - pairs arranged by parents. Children MUST be 3 years of age and older prior to the start of lessons.

Semi Private Lessons (8 x 30 min lessons) 8 pack - pairs arranged by parents. Children MUST be 3 years of age and older prior to the start of lessons.

Semi Private Lessons (12 x 30 min lessons) 12 pack - pairs arranged by parents. Children MUST be 3 years of age and older prior to the start of lessons.

Instructor Level Preference *

Instructor (1-4 years experience)

Coach (5+ years experience)

USA Swim Coach (10+ years experience)

Five Seasons Cancellation Policy

Please notify the instructor within 24 hours of the assigned/scheduled lesson in order to avoid being charged for the private lesson. Please exchange all contact information (Phone numbers and email addresses) with your assigned instructor to better assist communication needs.

Payment Method:

All Guests / Non Members must put a credit card on file prior to enrolling in classes. The Aquatics Department will reach out to you directly for this information once you've submitted this registration.

Please note there is a 3% processing fee on credit card transactions. *There is no processing fee on debit cards.

Members will be charged to account; non-members must provide payment information before first lesson takes place.

Facility Fee: Non-Members are subject to a $40 Facility Fee per swimmer.

Swim Packages: Packages must be purchased upon confirmation of the first scheduled lesson.

Financial Responsibility Agreement

I understand that I am financially responsible for all fees and dues associated with my child's program participation at Five Seasons Sports Club. Financially Responsible Parent/Guardian, please sign below.

Liability Waiver

I agree to abide by club rules and regulations. It is expressly agreed that all use of the club's facilities shall be undertaken at my sole risk, and the Club shall not be liable for injuries, loss or damages resulting from acts of active or passive negligence on the art of the club, its owners, officers, employees or agents.

Credit Card Number *

Credit Card Number Expiration Date *

Signature (Please type in your name) *

Submit

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