Assessment & Needs Form: I Am Me Mentors Swim Instruction
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Email *
Parent name *
Parent phone # *
Student name (fill out a separate form for every member of the family) *
I would like to start lessons for *
Student age *
Most flexible time range available *
What group is your swimmer enrolled in? (Include: time slot, instructor & location) N/A if this form is your first step
Which sites are you open to (please be as flexible as possible) *
Required
What is your swimmer's prior swimming and swim lesson experience? Please include qualities of the instructor, curriculum or lesson structure that they did or didn't respond well to. This is also the space to explain past trauma's in or around the water (if applicable).
How does your swimmer learn best? Check all that apply.
What cognitive, behavioral, physical or mental health support/accommodation needs should we be aware of? This often comes up midway through a course and is most helpful up front so we can accommodate the swimmer best through our lesson planning.
Check all that your swimmer can do... (advanced swimmers can skip the first 7 boxes)
For competitive swimmers, please list your swim times in key events and time/technique goals for swim instruction.
If you believe your swimmer requires private or semi-private lessons, please explain why
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