Private Lesson Request

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Private Lesson Request

Please Note: By filling out this request form, you are put on a waiting list for private lessons. There is no guarantee your private lessons will start in a set amount of time, although we will try our best to pace you with an available swim instructor as soon as possible.

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* Indicates required question

Start Date Requested *

MM

/

DD

/

YYYY

School Campus *

Kettering Campus

Mott Campus

No Preference

Swimmer's Name *

Your answer

Age *

Your answer

Gender *

Female

Male

Other:

Parent's Name *

Your answer

Phone Number *

Your answer

E-Mail Address *

Your answer

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