Padonia Park Club Swim Lessons
Swim Lesson Registration For Summer 2019
Participant's Name *
Your answer
Participant's Birthday *
Participant's Member Number *
Your answer
Parent/Guardian's Name and Best Contact Number *
Your answer
Have They Taken Lessons With Padonia Park Club in the Past? *
Please Select Which Type of Class You Wish to Enroll In *
Please Select Which Week(s) You Wish to Enroll. * Payment is Required to Hold Spots*
By Submitting this Form I Understand: *
Any Questions, Comments, or Concerns You Would Like the Supervisor to Know?
Your answer
Skill Assessment- *For New Participants Only*
Returning Participants Do Not Need To Fill Out Below. Please Scroll to the Bottom of the Form and Hit Submit
Can They Go Underwater, Completely Submerging Their Head and Without Holding Their Nose?
Can They Perform a Back Float? Child must float on the surface of the water without assistance getting into and maintaining the float with arms out and legs apart.
Can They Swim Front Crawl (Free Style)?
Can They Swim Back Crawl (Backstroke)?
Can They Swim Breast Stroke?
Can They Swim Butterfly?
Can They Swim Sidestroke?
Please submit this form and return to to complete step two of registration.
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