JCC Health Club Private Swim Request Form
Private Swim Lessons are for children and adults beginning at 12 months. Completing this form in its entirety is imperative to the private swim process. It does not mean lessons have been booked and confirmed. Please understand that JCC private swim lessons are always in high demand and that we will try to schedule your lessons as soon as possible.
Email address *
Date *
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Swimmer's Name *
Gender *
Swimmer's Date of Birth *
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Parent/Guardian Name *
Parent/Guardian Address *
City *
State *
Zip Code
Cell Phone Number *
Please Check the Swimmer's Membership Level *
Required
Please Check Instructors Gender Preference *
Required
Briefly define the swimmer's aquatic abilities and goals *
Based on the pool schedule available at http://www.jccmanhattan.org/about/hours-schedules/ indicate the days and times that you would prefer private swim instruction. *
Please indicate first, second, and third choices including: day, time, and pool.
Prices for lessons are as follows (prices subject to change):
Member Rates
Member Rates for 30 Minutes: $66
10-pack 30 Minutes: $589
Member Rates for 1 hour: $132
10-pack 1 hour: $1178

Public Rates
30 minutes: $89
10-pack 30 minutes: $801
Public Rates for 1 hour: $178
10-pack 1 hour: $1602

Semi Privates - Two or more swimmers
Member Rates
30 Minutes: $53
1 Hour: $403

Public Rates
30 Minutes: $72
10-pack 30 minutes: $640
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